Value of Nutritional Risk Screening 2002 and Mini Nutritional Assessment-Short Form in predicting the survival time of patients with malignant obstructive jaundice after surgery

Objective To investigate the value of Nutritional Risk Screening 2002 (NRS-2002) and Mini Nutritional Assessment-Short Form (MNA-SF) in assessing the nutritional status of patients with malignant obstructive jaundice (MOJ) and their association with overall survival (OS) after surgery. Methods A total of 78 patients with MOJ who attended Air Force Medical Center from January 2016 to January 2018 and underwent percutaneous transhepatic cholangial drainage and biliary stent implantation were enrolled. Nutritional screening was performed within 24 hours after admission. An analysis of variance was used for comparison of continuous data between multiple groups, and the SNK-q test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. The consistency test was used to evaluate the consistency between NRS-2002 and MNA-SF. A multivariate linear regression analysis was used to investigate the independent influencing factors for NRS-2002 and MNA-SF, and univariate and multivariate Cox regression analyses were used to identify the independent risk factors for OS. The log-rank test was used for comparison of OS between patients with different nutritional status. Results According to NRS-2002, there were 10 patients with normal nutrition (12. 8%) , 53 patients with the risk of malnutrition (67. 9%) , and 15 patients with malnutrition (19. 2%) . According to MNA-SF, there were 7 patients with normal nutrition (9. 0%) , 32 patients with the risk of malnutrition (41. 0%) , and 39 patients with malnutrition (50. 0%) . Age and body mass index were independent influencing factors for NRS-2002 and MNA-SF (all P < 0. 05) . There was good consistency between NRS-2002 and MNA-SF (Kappa = 0. 418, P < 0. 001) . Both nutritional scales showed that the patients with malnutrition had significantly shorter OS than those with the risk of malnutrition or normal nutrition (χ2= 42. 081, P < 0. 001) , and the patients with the risk of malnu-trition had significantly shorter OS than those with normal nutrition (χ2= 33. 723, P < 0. 001) . Malnutrition based on NRS-2002 (hazard ratio [HR]= 3. 874, 95% confidence interval [CI]: 1. 065-14. 099) , risk of malnutrition based on MNA-SF (HR = 15. 544, 95% CI:2. 324-103. 968) , and malnutrition (HR = 42. 535, 95% CI: 6. 179-292. 798) were independent influencing factors for OS (P < 0. 05) .Conclusion MNA-SF is superior to NRS-2002 in screening the nutritional status of MOJ patients and can predict OS more accurately.Therefore, it is recommended as a nutritional screening tool for MOJ patients on admission and nutritional intervention can be given based on the results of screening.