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Comparison of Three Malnutrition Screening Tools Prior to Allogeneic Hematopoietic Stem-Cell Transplantation Publisher



Khosroshahi RA1 ; Mohammadi H1 ; Barkhordar M2, 3 ; Zeraattalabmotlagh S4 ; Imani H1 ; Rashidi A2, 3 ; Sadeghi E5 ; Wilkins S6, 7 ; Mousavi SA2, 3
Authors
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Authors Affiliations
  1. 1. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  5. 5. Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Cabrini Monash Department of Surgery, Cabrini Hospital, Melbourne, VIC, Australia
  7. 7. Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, Australia

Source: Frontiers in Nutrition Published:2023


Abstract

Background: Previous studies have shown that malnutrition before hematopoietic stem cell transplantation (HSCT) is associated with poor patient prognoses. There is inconsistency among studies on which nutritional status screening tool is appropriate for malnutrition diagnosis before allo-HSCT. The present study aimed to compare nutritional screening tools in patients with leukemia before allo-HSCT. Methods: An observational, cross-sectional, and single-center study was conducted in Tehran, Iran. One hundred four adults allo-HSCT candidates aged 18-55 years with leukemia were selected sequentially. Malnutrition assessment was done using three tools, the Global Leadership Initiative on Malnutrition (GLIM), nutritional risk screening 2002 (NRS-2002) and European Society for Clinical Nutrition and Metabolism (ESPEN) criteria. The agreement between malnutrition assessment tools was evaluated with Cohen’s kappa. Results: The agreement between GLIM and NRS-2002 was perfect (κ = 0.817, p < 0.001), while the agreement between GLIM and ESPEN was fair (κ = 0.362, p < 0.001). The agreement between NRS-2002 and ESPEN was fair (κ = 0.262, p < 0.001). We also found a moderate agreement for all tools (κ = 0.489, p < 0.001). Conclusion: NRS-2002 is an accepted tool for screening malnutrition in hospitalized patients. In the current study, the GLIM criterion perfectly agreed with the NRS-2002. Further studies in the HSCT setting are needed to introduce a valid tool. Copyright © 2023 Khosroshahi, Mohammadi, Barkhordar, Zeraattalab-Motlagh, Imani, Rashidi, Sadeghi, Wilkins and Mousavi.