Jomyaku Keicho Eiyo

We examined the concentrations of water-soluble vitamins including vitamin B₁, B₂, B₆, B₁₂, C, and folate, and homocysteine in the fasting patients on acute stage with stroke and gastrointestinal diseases, who received peripheral parenteral nutrition without addition of these vitamins for 3 to 7 days. On admission, all patients showed low levels of vitamin B₆ and C. Especially, the patients with gastrointestinal diseases showed the low concentrations of all vitamin B₁, B₂, B₆, B₁₂, C, folate, which decreased furthermore to the lower levels during the observation period. The patients with stroke also revealed the similar changes. These results showed that these vitamins should be added to the peripheral parenteral nutrition in fasting patients.

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Aim:Subjective global assessment (SGA) is a clinical tool for assessing nutritional status and has been widely used for nutritional screening of hospitalized patients. Furthermore, SGA has been reported to be useful as a prognostic indicator in several clinical situations such as renal failure, stroke and major surgery. However, clinical usefulness of SGA in inflammatory bowel disease has been unknown. In this study, we assess the clinical importance of SGA in the hospitalized patients with Crohn's disease.
Methods:Twenty-seven patients with Crohn's disease (19 male and 8 females) were enrolled in this study. The mean age of patients was 30.7 years old, and disease was the ileitis type in 5 patients, ileocolitis type in 16 patients and colitis type in 6 patients. SGA was assessed by gastroenterologist on admission. We assessed some relationships of SGA and disease activity, selected tool of nutritional management and therapeutic option, and length of stay.
Results:On admission, 10 patients were assessed as good nutritional status, and 11 patients were assessed as moderately malnourished status, and 6 patients were assessed as severely malnourished status by SGA. There were significant correlations between nutritional status and disease activities. Moderately and severely malnourished patients had high risk of total parenteral nutrition therapy and surgical treatment compared with good nourished patients, and malnourished patients had significant longer length of stay.
Conclusions:SGA is an excellent predictor of outcome in patients with Crohn's disease. Moderately and severely malnourished patients have significant higher risk of total parenteral nutrition and surgical treatment.

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