Annals of Clinical Nutrition and Metabolism

Hyuk-Joon Lee

10 Articles

Development and Internal/External Validation of a Prediction Model for Weight Loss Following Gastric Cancer Surgery: A Multicenter Retrospective Study: Ji-Hyeon Park, Seong-Ho Kong, Do Joong Park, Han-Kwang Yang, Jong Won Kim, Ki Bum Park, In Cho, Sun-Hwi Hwang, Dong-Wook Kim, Su Mi Kim, Seung-Wan Ryu, Seong Chan Gong, Pil Young Jung, Hoon Ryu, Sung Geun Kim, Chang In Choi, Dae-Hwan Kim, Sung-IL Choi, Ji-Ho Park, Dong Jin Park, Gyu-Yeol Kim, Yunhee Choi, Hyuk-Joon Lee; Ann Clin Nutr Metab 2022;14(2):55-65. Published online December 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.2.55

Purpose: To develop an individualized model for predicting the extent of unintentional weight loss following gastrectomy in patients with gastric cancer based on related risk factors and to externally validate this model using multicenter clinical data in Korea.
Materials and Methods: Among gastric cancer patients who underwent curative gastrectomy at 14 different gastric cancer centers, clinical data from patients with more than one weight measurement during the three-year follow-up period were retrospectively collected. Risk factors associated with weight loss in gastric cancer patients after gastrectomy were analyzed, and a predictive model was developed. Internal and external validation were performed.
Results: The data from 2,649 patients were divided into a derivation set (n=1,420 from Seoul National University Hospital) and validation set (n=1,229 from 13 different gastric cancers). Postoperative duration (six vs. 12, 24, or 36 months), sex (female vs. male), age, preoperative body mass index, type of surgery (pylorus-preserving vs. total, distal or proximal gastrectomy), and cancer stage (I vs. II or III) were included in the final prediction model. The model showed approximately 20% accuracy in predicting weight loss at each period: R2 at six, 12, 24 and 36 months after gastrectomy in internal validation=0.20, 0.21, 0.17, and 0.18, respectively, and in external validation=0.20, 0.22, 0.18, and 0.18, respectively. Calibration slopes of internal and external validation were 0.95 and 1.0, respectively.
Conclusion: Although predictive accuracy of the model did not reach an acceptable level, repeated external validation measurements showed high reliability. The model may serve as a basic reference in clinical practice.

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Development and Feasibility Assessment of Mobile Application-Based Digital Therapeutics for Postoperative Supportive Care in Gastric Cancer Patients Following Gastrectomy
Ji-Hyeon Park, Hyuk-Joon Lee, JeeSun Kim, Yo-Seok Cho, Sunjoo Lee, Seongmin Park, Hwinyeong Choe, Eunhwa Song, Youngran Kim, Seong-Ho Kong, Do Joong Park, Byung-Ho Nam, Han-Kwang Yang
Journal of Gastric Cancer.2024; 24(4): 420. CrossRef

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Long-Term Changes of Body Mass Index and Nutritional Biochemical Markers in the Obese Elderly with Gastric Cancer: Eunjung Kim, Ji-Hyeon Park, Eun-Mi Seol, Seong-Ho Kong, Do Joong Park, Han-Kwang Yang, Hyuk-Joon Lee; Ann Clin Nutr Metab 2021;13(2):52-61. Published online December 31, 2021; DOI: https://doi.org/10.15747/ACNM.2021.13.2.52

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Effect of Malnutrition Assessed by Comprehensive Nutritional Screening Tool on In-Hospital Mortality after Surgery for Gastrointestinal Perforation: Seung-Young Oh, Hannah Lee, Ho Geol Ryu, Hyuk-Joon Lee; Surg Metab Nutr 2021;12(1):1-6. Published online June 30, 2021; DOI: https://doi.org/10.18858/smn.2021.12.1.1

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Purpose: This study examined the effects of malnutrition on in-hospital mortality after surgery for gastrointestinal (GI) perforation.
Materials and Methods: Patients who underwent surgery for GI perforation between 2010 and 2017 were analyzed retrospectively. The preoperative nutritional status was assessed by the Seoul National University Hospital-Nutrition Screening Index, a tool that comprehensively evaluates 11 factors that reflect the nutritional status. The risk factors for in-hospital mortality after surgery for GI perforation were evaluated by univariate and multivariate analyses.
Results: Four hundred and eighty-nine patients were divided into two groups: 439 patients in the survival group and 50 patients in the in-hospital mortality group. The risk of malnutrition was higher (93.6% vs. 65.9%, P<0.001) in the in-hospital mortality group than in the survival group. The preoperative albumin level was lower, and the blood urea nitrogen level was higher in the in-hospital mortality group than in the survival group. Emergency surgery, lymphoma as a cause of perforation, and fecal-contaminated ascites were also identified as factors associated with in-hospital mortality. Multivariate analyses demonstrated that a high risk of malnutrition (HR=5.71, 95% CI 1.38~26.02, P=0.017), lymphoma as a cause of perforation (HR=4.12, 95% CI 1.17~14.51, P=0.028), low preoperative albumin (HR=4.77, 95% CI 2.35~9.69, P<0.001), and high preoperative BUN (HR=1.03, 95% CI 1.01~1.05, P=0.001) had significant effects on the in-hospital mortality after surgery for GI perforation.
Conclusion: A high risk of malnutrition assessed by the composite index was associated with in-hospital mortality after surgery for a GI perforation.

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Performance of the comprehensive nutrition screening index in predicting mortality after cardiac surgery
Jaeyeon Chung, Jinyoung Bae, Seyong Park, Dong Hyouk Kim, Youn Joung Cho, Karam Nam, Yunseok Jeon, Jae-Woo Ju
Scientific Reports.2024;[Epub] CrossRef
Efficacy of nutritional support protocol for patients with pressure ulcer: comparison of before and after the protocol
Hye Young Woo, Seung-Young Oh, Leerang Lim, Hyunjae Im, Hannah Lee, Ho Geol Ryu
Nutrition.2022; 99-100: 111638. CrossRef

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Nutritional Therapy Related Complications in Hospitalized Adult Patients: A Korean Multicenter Trial: Eun-Mi Seol, Kye Sook Kwon, Jeong Goo Kim, Jung-Tae Kim, Jihoon Kim, Sun-Mi Moon, Do Joong Park, Jung Hyun Park, Je Hoon Park, Ji Young Park, Jung-Min Bae, Seung Wan Ryu, Ji-Young Sul, Dong Woo Shin, Cheung Soo Shin, Byung Kyu Ahn, Soo Min Ahn, Hee Chul Yu, Gil Jae Lee, Sanghoon Lee, A Ran Lee, Jae Young Jang, Hyun Jeong Jeon, Sung Min Jung, Sung-Sik Han, Suk-Kyung Hong, Sun-Hwi Hwang, Yunhee Choi, Hyuk-Joon Lee; J Clin Nutr 2019;11(1):12-22. Published online June 30, 2019; DOI: https://doi.org/10.15747/jcn.2019.11.1.12

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Purpose:

Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking.

Methods:

Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients’ demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected.

Results:

A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m². The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; “micronutrient and vitamin deficiency” (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay.

Conclusion:

NT may induce or be associated with several complications, and some of them may seriously affect the patient’s outcome. NST personnel in each hospital should be aware of each problem during nutritional support.

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Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
Annals of Clinical Nutrition and Metabolism.2022; 14(2): 66. CrossRef
Pathophysiology and protective approaches of gut injury in critical illness
Chang Yeon Jung, Jung Min Bae
Yeungnam University Journal of Medicine.2021; 38(1): 27. CrossRef
Nutrition Support Team Reconsultation During Nutrition Therapy in Korea
Eun‐Mi Seol, Yun‐Suhk Suh, Dal Lae Ju, Hye Jung Bae, Eunjung Kim, Hyuk‐Joon Lee
Journal of Parenteral and Enteral Nutrition.2021; 45(2): 357. CrossRef

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Characteristics and Clinical Course of Patients Who Received Enteral or Parenteral Nutrition in Tertiary Referral Hospitals in Korea: Eunmi Seol, Yun-Suhk Suh, Dal Lae Ju, Hye Jung Bae, Hyuk-Joon Lee; J Clin Nutr 2016;8(2):58-65. Published online August 31, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.2.58

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Purpose:

The purposes of this study are to evaluate clinical characteristics of malnourished patients who received nutritional therapy and to compare their clinical courses according to nutritional support team (NST) consultation in tertiary referral hospital in Korea.

Methods:

From June 2014 to May 2015, 43,954 admitted patients who were more than 18 years old were retrospectively investigated. Characteristics of patients who received enteral nutrition (EN) or parenteral nutrition (PN) for more than 3 days (nutritional therapy group) were compared to the patients without nutritional therapy (control group). In addition, clinical courses according to NST consultation (NST group and non-NST group) were compared through propensity score matching (PSM).

Results:

EN or PN was applied in 4,599 patients for more than 3 days (nutritional therapy group: 10.5%). For characteristics, there were significant differences between two groups (nutritional therapy group vs. control group) with age, male proportion, body weight, body mass index. All laboratory data at admission were significantly worse in nutritional therapy group. And for clinical courses, there were significant differences in length of stay (LOS), rate of intensive care unit (ICU) admission, LOS in ICU, Acute Physiology and Chronic Health Enquiry (APACHE II) score, days of nutritional therapy, mortality rate. NST consultation was made in 39% of nutritional therapy group. Among departments, Thoracic Surgery showed the highest rate of NST consultation (68.5%) otherwise Neurosurgery showed the lowest rate (18.7%). When PSM between NST group vs. non-NST group were made, significant differences was shown only in the rate of ICU admission, EN or PN support days, cholesterol at discharge.

Conclusion:

In tertiary referral hospital in Korea, more than 10% of patients still needed active nutritional therapy. NST consultation rate varies among departments. We failed to find significant differences between NST group and non-NST group.

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Early nutritional support for inpatients reduces admission rates to intensive care units in Korea: a single-center case-control study
Hyun Suk Kim, Jae Do Yang, Se Wung Han, Mi Rin Lee, Da-Sol Kim, Sejin Lee, Seon-Hyeong Kim, Chan-Young Kim
Annals of Clinical Nutrition and Metabolism.2024; 16(2): 57. CrossRef
Report on the Current Trend of Commercial Enteral/Parenteral Nutrition in Outpatient
Hyun Ji Lee, Hyo Jung Park, Seon Young Chung, Myung Sook Min, Ok Soon Jeong, Ja Kyung Min
Journal of Korean Society of Health-System Pharmacists.2023; 40(2): 211. CrossRef
Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations
Yunjin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2022; 27(2): 121. CrossRef
Physician Compliance with Nutrition Support Team Recommendations: Effects on the Outcome of Treatment for Critically Ill Patients
Hyon-Ju Yon, Eun-Suk Oh, Ji Young Jang, Ji Yun Jang, Hongjin Shim
Journal of Acute Care Surgery.2022; 12(1): 1. CrossRef
Path Analysis for Delirium on Patient Prognosis in Intensive Care Units
Sunhee Lee, Sun-Mi Lee
Journal of Korean Academy of Nursing.2019; 49(6): 724. CrossRef

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Letter from Editor: Hyuk-Joon Lee; J Clin Nutr 2016;8(1):1-1. Published online April 30, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.1.1

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Barriers and potential facilitators to implement nutrition care program in athletes’ training centers in Indonesia
Mustika Cahya Nirmala Dewinta, Mirza Hapsari Sakti Titis Penggalih, Digna Niken Purwaningrum
Nutrition and Health.2022;[Epub] CrossRef

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Nutritional Screening Tool for In-Hospital Patients: Eunmi Seol, Dal Lae Ju, Hyuk-Joon Lee; J Clin Nutr 2016;8(1):2-10. Published online April 30, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.1.2

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Malnutrition is a common problem in hospital settings. A poor nutritional status has been associated with higher rates of infection, poor wound healing, longer hospital stays, and higher hospital costs. Therefore, early recognition and timely treatment of malnutrition is vital. To identify malnourished individuals or those at risk of becoming malnourished, selecting and validated a uniform screening tool is clearly an important issue. Both the Nutritional Risk Screening-2002 (NRS-2002) and Malnutrition Universal Screening Tool (MUST) are recommended by the European Society for Parenteral and Enteral Nutrition (ESPEN) for a hospital setting. For older patients, the Mini Nutritional Assessment (MNA) is the recommended tool. Short Nutrition Assessment Questionnaire (SNAQ) and Malnutrition Screening Tools (MST) are brief and simple screening tools that use self-reported queries of variables that include weight loss and poor appetite. On the other hand, many of those require considerable time and labor to administer and may not be highly applicable to a Korean population. In Korea, most hospitals use a computerized nutritional screening system with a self-developed nutrition screening index. The variables for the tools, which are based on each hospital setting, include the objective data available in the patient’s medical records and limited information collected from the nursing admission questionnaire. The application of different tools hampers any comparison of the malnutrition prevalence between different settings and patients groups. In addition, the absence of a widely accepted malnutrition screening tool hinders both effective recognition and the treatment of malnutrition. Therefore, the development of uniform and valid screening tools and effective nutritional support programs for Korean malnourished patients is needed.

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The Status of Enteral Nutrition Formula Use by Dietitians in Hospitals Within Busan and Gyeongnam Area
Haejin Kang, Minji Woo, Eunju Park, Yoo Kyoung Park
Clinical Nutrition Research.2022; 11(1): 9. CrossRef
Comparison of mNUTRIC-S2 and mNUTRIC scores to assess nutritional risk and predict intensive care unit mortality
So Jeong Kim, Hong Yeul Lee, Sun Mi Choi, Sang-Min Lee, Jinwoo Lee
Acute and Critical Care.2022; 37(4): 618. CrossRef
Comparison of the nutritional indicators of critically Ill patients on extracorporeal membrane oxygen (ECMO)
Nah-Mee Shin, Suk Yeon Ha, Yoon Soo Cho
Journal of Nutrition and Health.2021; 54(5): 489. CrossRef
Improvement of the Dietary Stage on Dysphagia in Geriatric Hospitals
Ji Eun Lee, Eun Jeong Lee
Journal of the Korean Dysphagia Society.2018; 8(1): 41. CrossRef
Effect of Active Nutrition Care on Underweight Elderly Patients Receiving Long-term Enteral Tube Feeding
Hwa-Young Yoon, Hye-Kyeong Kim
Korean Journal of Community Nutrition.2018; 23(1): 48. CrossRef
Impact of nutritional screening index on perioperative morbidity after colorectal cancer surgery as a independent predictive factor
Yoon Hyung Kang, Ji Won Park, Seung Bum Ryoo, Seung Yong Jeong, Kyu Joo Park
Korean Journal of Clinical Oncology.2017; 13(2): 118. CrossRef

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Letter from Editor: Hyuk-Joon Lee; J Clin Nutr 2015;7(3):69-69. Published online December 31, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.3.69

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Letter from Editor: Hyuk-Joon Lee; J Clin Nutr 2015;7(2):35-35. Published online August 31, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.2.35

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Letter from Editor: Hyuk-Joon Lee; J Clin Nutr 2015;7(1):1-1. Published online April 30, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.1.1

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A community-based study on lower urinary tract symptoms in Malaysian males aged 40 years and above
Mohamad Fuad Mohamad Anuar, Muhammad Solihin Rezali, Mohamed Ashraf Mohamed Daud, Shaiful Bahari Ismail
Scientific Reports.2022;[Epub] CrossRef

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