nach oben

Erschienen in:

01.01.2016 | Original Article

Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES^® study

verfasst von: Mercè Planas, Julia Álvarez-Hernández, Miguel León-Sanz, Sebastián Celaya-Pérez, Krysmarú Araujo, Abelardo García de Lorenzo, on behalf of the PREDyCES® researchers

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

In oncology patients, hospital malnutrition is associated with a greater risk of morbidity and mortality. The objective of this study was to determine the prevalence of nutritional risk and the clinical and economic consequences of hospital malnutrition in oncology patients hospitalised in Spanish centres.

Methods

This was an observational, cross-sectional, multicentre study. The prevalence of nutritional risk was determined using the Nutrition Risk Screening^®-2002 (NRS^®-2002).

Results

Four hundred one oncology patients were included; 33.9 % (136/401) were at nutritional risk (NRS^®-2002 ≥ 3) at admission and 36.4 % (135/371) at discharge. On average, patients at nutritional risk were more elderly and had lower weights, body mass indices and arm and calf circumferences, as well as lower serum albumin levels than patients not at risk. Mean duration of hospitalisation and healthcare costs were greater in patients at nutritional risk at discharge (12.1 days; 95 % confidence interval (CI) 10.83–13.39) than in well-nourished patients (8.6 days; 95 % CI 7.86–9.40). Only a third of the patients at risk of malnutrition at discharge had received any kind of nutritional support.

Conclusions

This study shows that hospital malnutrition is a prevalent and undertreated condition in oncology patients that is associated with longer hospital stays and increased healthcare costs.

Norman K, Pichard C, Lochs H, Pirlich M (2008) Prognostic impact of disease-related malnutrition. Clin Nutr 27(1):5–15CrossRefPubMed

Correia MI, Hegazi RA, Higashiguchi T, Michel JP, Reddy BR, Tappenden KA, Uyar M, Muscaritoli M (2014) Evidence-based recommendations for addressing malnutrition in health care: an updated strategy from the feedM.E. Global Study Group. J Am Med Dir Assoc 15(8):544–550CrossRefPubMed

Kwag SJ, Kim JG, Kang WK, Lee JK, Oh ST (2014) The nutritional risk is an independent factor for postoperative morbidity in surgery for colorectal cancer. Ann Surg Treat Res 86(4):206–211PubMedCentralCrossRefPubMed

Yu K, Zhou XR, He SL (2013) A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer. Eur J Clin Nutr 67(7):732–737CrossRefPubMed

Vashi PG, Gupta D, Lammersfeld CA, Braun DP, Popiel B, Misra S, Brown KC (2013) The relationship between baseline nutritional status with subsequent parenteral nutrition and clinical outcomes in cancer patients undergoing hyperthermic intraperitoneal chemotherapy. Nutr J 12:118PubMedCentralCrossRefPubMed

Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34(3):137–168CrossRefPubMed

Fiorelli A, Vicidomini G, Mazzella A, Messina G, Milione R, Di Crescenzo VG, Santini M (2014) The influence of body mass index and weight loss on outcome of elderly patients undergoing lung cancer resection. Thorac Cardiovasc Surg 62(7):578–587CrossRefPubMed

Rey-Ferro M, Castaño R, Orozco O, Serna A, Moreno A (1997) Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery. Nutrition 13(10):878–881CrossRefPubMed

Gupta D, Lis CG, Granick J, Grutsch JF, Vashi PG, Lammersfeld CA (2006) Malnutrition was associated with poor quality of life in colorectal cancer: a retrospective analysis. J Clin Epidemiol 59(7):704–709CrossRefPubMed

10.

Jager-Wittenaar H, Dijkstra PU, Vissink A, van der Laan BF, van Oort RP, Roodenburg JL (2011) Malnutrition and quality of life in patients treated for oral or oropharyngeal cancer. Head Neck 33(4):490–496CrossRefPubMed

11.

Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG (2012) Role of nutritional status in predicting quality of life outcomes in cancer—a systematic review of the epidemiological literature. Nutr J 11:27PubMedCentralCrossRefPubMed

12.

Ma L, Wu T, Pan J, Kong X, Guo Q, Yang L, Zhang Y, Lin S, Chen C, Huang C (2014) The correlation between the comprehensive nutrition index and quality of life of patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy. Nutr Cancer 66(1):152–158CrossRefPubMed

13.

Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9(Suppl 2):S51–S63CrossRefPubMed

14.

Nicolini A, Ferrari P, Masoni MC, Fini M, Pagani S, Giampietro O, Carpi A (2013) Malnutrition, anorexia and cachexia in cancer patients: a mini-review on pathogenesis and treatment. Biomed Pharmacother 67(8):807–817CrossRefPubMed

15.

Von Haehling S, Anker SD (2010) Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachex Sarcopenia Muscle 1(1):1–5CrossRef

16.

Tong H, Isenring E, Yates P (2009) The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer 17(1):83–90CrossRefPubMed

17.

Olsson U, Bosaeus I, Svedlund J, Bergbom I (2007) Patients’ subjective symptoms, quality of life and intake of food during the recovery period 3 and 12 months after upper gastrointestinal surgery. Eur J Cancer Care (Engl) 16(1):74–85CrossRef

18.

Russi EG, Raber-Durlacher JE, Sonis ST (2014) Local and systemic pathogenesis and consequences of regimen-induced inflammatory responses in patients with head and neck cancer receiving chemoradiation. Mediat Inflamm 2014:518261

19.

Silver HJ, Dietrich MS, Murphy BA (2007) Changes in body mass, energy balance, physical function, and inflammatory state in patients with locally advanced head and neck cancer treated with concurrent chemoradiation after low-dose induction chemotherapy. Head Neck 29(10):893–900CrossRefPubMed

20.

Baldwin C, McGough C, Spiro A, Thomas K, Cunningham DC, Andreyev HJN (2009) Nutritional and clinical characteristics of patients with gastrointestinal tract (GI) cancers at presentation. Proceedings of the Nutrition Society 68(OCE1)

21.

Andreyev HJ, Norman AR, Oates J, Cunningham D (1998) Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer 34(4):503–509CrossRefPubMed

22.

Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass Jr HO, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ, Moertel CG, Oken MM, Perlia C, Rosenbaum C, Silverstein MN, Skeel RT, Sponzo RW, Tormey DC (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69(4):491–497CrossRefPubMed

23.

Segura A, Pardo J, Jara C, Zugazabeitia L, Carulla J, de Las PR, García-Cabrera E, Luz Azuara M, Casadó J, Gómez-Candela C (2005) An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer. Clin Nutr 24(5):801–814CrossRefPubMed

24.

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 22(4):415–421CrossRefPubMed

25.

Álvarez-Hernández J, Planas Vila M, León-Sanz M, García de Lorenzo A, Celaya-Pérez S, García-Lorda P, Araujo K, Sarto Guerri B (2012) PREDyCES researchers. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES study. Nutr Hosp 27(4):1049–1059PubMed

26.

Planas Vila M, Álvarez Hernández J, García de Lorenzo A, Celaya Pérez S, León Sanz M, García-Lorda P, Brosa M (2010) The burden of hospital malnutrition in Spain: methods and development of the PREDyCES^® study. Nutr Hosp 25(6):1020–1024PubMed

27.

Olivares J, Ayala L, Salas-Salvadó J, Muñiz MJ, Gamundí A, Martínez-Indart L, Masmiquel LL (2014) Assessment of risk factors and test performance on malnutrition prevalence at admission using four different screening tools. Nutr Hosp 29(3):674–680PubMed

28.

Mercadal-Orfila G, Lluch-Taltavull J, Campillo-Artero C, Torrent-Quetglas M (2012) Association between nutritional risk based on the NRS-2002 test and hospital morbidity and mortality. Nutr Hosp 27(4):1248–1254PubMed

29.

Velasco C, García E, Rodríguez V, Frias L, Garriga R, Alvarez J, García-Peris P, León M (2011) Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study. Eur J Clin Nutr 65(2):269–274CrossRefPubMed

30.

Gur AS, Atahan K, Aladag I, Durak E, Cokmez A, Tarcan E, Tavusbay C (2009) The efficacy of Nutrition Risk Screening-2002 (NRS-2002) to decide on the nutritional support in general surgery patients. Bratisl Lek Listy 110(5):290–292PubMed

31.

Bozzetti F, Mariani L, Lo Vullo S, SCRINIO Working Group, Amerio ML, Biffi R, Caccialanza G, Capuano G, Correja I, Cozzaglio L, Di Leo A, Di Cosmo L, Finocchiaro C, Gavazzi C, Giannoni A, Magnanini P, Mantovani G, Pellegrini M, Rovera L, Sandri G, Tinivella M, Vigevani E (2012) The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer 20(8):1919–1928PubMedCentralCrossRefPubMed

32.

Gheorghe C, Pascu O, Iacob R, Vadan R, Iacob S, Goldis A, Tantau M, Dumitru E, Dobru D, Miutescu E, Saftoiu A, Fraticiu A, Tomescu D, Gheorghe L (2013) Nutritional risk screening and prevalence of malnutrition on admission to gastroenterology departments: a multicentric study. Chirurgia (Bucur) 108(4):535–541

33.

Alvarez-Altamirano K, Delgadillo T, García-García A, Alatriste-Ortiz G, Fuchs-Tarlovsky V (2014) Prevalence of nutritional risk evaluated with nrs-2002 in Mexican oncology population. Nutr Hosp 30(1):173–178PubMed

34.

Illa P, Tomíšková M, Skřičková J (2014) Screening of malnutrition risk versus indicators of nutritional status and systemic inflammatory response in newly diagnosed lung cancer patients]. Klin Onkol 27(4):261–268CrossRefPubMed

35.

Tangvik RJ, Tell GS, Guttormsen AB, Eisman JA, Henriksen A, Nilsen RM, Ranhoff AH (2014) Nutritional risk profile in a university hospital population. Clin Nutr S0261-5614(14)00205-00202. doi:10.1016/j.clnu.2014.08.001

36.

Freijer K, Bours MJ, Nuijten MJ, Poley MJ, Meijers JM, Halfens RJ, Schols JM (2014) The economic value of enteral medical nutrition in the management of disease-related malnutrition: a systematic review. J Am Med Dir Assoc 15(1):17–29CrossRefPubMed

37.

Arends J, Bodoky G, Bozzetti F, Fearon K, Muscaritoli M, Selga G, van Bokhorst-de van der Schueren MA, von Meyenfeldt M, DGEM (German Society for Nutritional Medicine), Zürcher G, Fietkau R, Aulbert E, Frick B, Holm M, Kneba M, Mestrom HJ, Zander A (2006) ESPEN (European Society for Parenteral and Enteral Nutrition). ESPEN guidelines on enteral nutrition: non-surgical oncology. Clin Nutr 25(2):245–259CrossRefPubMed

38.

Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M, ESPEN (2009) ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr 28(4):445–454CrossRefPubMed

39.

Bosch R, García A, Mañas A (2008) Guía clínica multidisciplinar sobre el manejo de la nutrición en el paciente con cáncer. http://www.oncologiaynutricion.com/archivos/pubs/libroconsenso.pdf. Accessed: 18 Mar 2015

40.

Platek ME, Popp JV, Possinger CS, Denysschen CA, Horvath P, Brown JK (2011) Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal, and lung cancer patients by 3 classification methods. Cancer Nurs 34(5):410–416PubMedCentralCrossRefPubMed

41.

Pressoir M, Desné S, Berchery D, Rossignol G, Poiree B, Meslier M, Traversier S, Vittot M, Simon M, Gekiere JP, Meuric J, Serot F, Falewee MN, Rodrigues I, Senesse P, Vasson MP, Chelle F, Maget B, Antoun S, Bachmann P (2010) Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer 102(6):966–971PubMedCentralCrossRefPubMed

42.

Amaral TF, Antunes A, Cabral S, Alves P, Kent-Smith L (2008) An evaluation of three nutritional screening tools in a Portuguese oncology centre. J Hum Nutr Diet 21(6):575–583CrossRefPubMed

43.

Gavazzi C, Colatruglio S, Sironi A, Mazzaferro V, Miceli R (2011) Importance of early nutritional screening in patients with gastric cancer. Br J Nutr 106(12):1773–1778CrossRefPubMed

44.

Takahashi H, Chiba T, Tairabune T, Kimura Y, Wakabayashi G, Takahashi K, Kudo K (2014) A retrospective study on the influence of nutritional status on pain management in cancer patients using the transdermal fentanyl patch. Biol Pharm Bull 37(5):853–857CrossRefPubMed

45.

Isenring EA, Capra S, Bauer JD (2004) Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91(3):447–452PubMedCentralCrossRefPubMed

46.

Moreland SS (2012) Nutrition screening and counseling in patients with lung cancer in an outpatient setting. J Adv Pract Oncol 3(3):191–193PubMedCentralPubMed

47.

Tan CR, Yaffee PM, Jamil LH, Lo SK, Nissen N, Pandol SJ, Tuli R, Hendifar AE (2014) Pancreatic cancer cachexia: a review of mechanisms and therapeutics. Front Physiol 5:88PubMedCentralCrossRefPubMed

Titel: Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study
verfasst von: Mercè Planas
Julia Álvarez-Hernández
Miguel León-Sanz
Sebastián Celaya-Pérez
Krysmarú Araujo
Abelardo García de Lorenzo
on behalf of the PREDyCES® researchers
Publikationsdatum: 01.01.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 1/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2813-7

Neu im Fachgebiet Onkologie

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Bestrahlung nach Prostatektomie: mehr Schaden als Nutzen?

02.05.2024 Prostatakarzinom Nachrichten

Eine adjuvante Radiotherapie nach radikaler Prostata-Op. bringt den Betroffenen wahrscheinlich keinen Vorteil. Im Gegenteil: Durch die Bestrahlung steigt offenbar das Risiko für Harn- und Stuhlinkontinenz.

ASS schützt nicht vor Brustkrebsrezidiven

02.05.2024 Mammakarzinom Nachrichten

Nützt nichts und ist vielleicht sogar schädlich: In einer Phase-3-Studie konnten täglich 300 mg ASS keine Brustkrebsrezidive bei Frauen vermeiden, die ein hohes Risiko für eine Tumorrückkehr aufwiesen. Tendenziell traten unter ASS sogar häufiger Rezidive auf als unter Placebo.

CUP-Syndrom: Künstliche Intelligenz kann Primärtumor finden

30.04.2024 Künstliche Intelligenz Nachrichten

Krebserkrankungen unbekannten Ursprungs (CUP) sind eine diagnostische Herausforderung. KI-Systeme können Pathologen dabei unterstützen, zytologische Bilder zu interpretieren, um den Primärtumor zu lokalisieren.

Bildnachweise

Frau nutzt Gehhilfe /© Photographee.eu / Fotolia (Symbolbild mit Fotomodellen), Darstellung der Dosisverteilung bei Bestrahlung eines Prostatakarzinoms/© Degener, S et al. / all rights reserved Springer Medizin Verlag GmbH, Frau mit Tablette und Wasserglas in Händen/© fizkes / stock.adobe.com (Symbolbild mit Fotomodell), Ärztin und künstliche Intelligenz sehen sich Befunde an/© Alexander Limbach / Zoonar/picture alliance (Symbolbild mit Fotomodell)

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES^® study