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Published in: The journal of nutrition, health & aging 2/2020

01-02-2020 | Malnutrition

Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter and Multiregional Study

Authors: Cristiane A. D’Almeida, W. A. F. Peres, N. B. de Pinho, R. B. Martucci, V. D. Rodrigues, A. Ramalho

Published in: The journal of nutrition, health & aging | Issue 2/2020

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Abstract

Background

Malnutrition is frequent in older cancer patients, with a prevalence that ranges from 25% to 85%. The aging process is associated with several physiological changes, which may have implications for nutritional status. Screening tools can be useful for identifying malnutrition status among older patients with cancer.

Methods

A hospital-based multicenter cohort study that included 44 institutions in Brazil. The Mini Nutritional Assessment-Short Form (MNA-SF) was administered to 3061 older hospitalized cancer patients within 48 hoursof admission. The Kolmogorov-Smirnov test was used to test the sample distribution, considering sex, age range, calf circumference, body mass index, and MNA-SF score and classification. The categorical data were expressed by frequencies (n) and percentages (%)and compared using the chi-square test or Tukey test.

Results

According to the results of the MNA-SF, 33.4% of the patients were malnourished, 39.3% were at risk of malnutrition, and 27.3% were classified as having normal nutritional status. Length of hospital stay (in days) was found to be longer for those patients with a poorer nutritional status (malnourished: 7.07±7.58; at risk of malnutrition: 5.45±10.73; normal status: 3.9±5,84; p <0.001).

Conclusions

The prevalence of malnutrition and nutritional risk is high in older hospitalized cancer patients in all the regions of Brazil and a worse nutritional status is associated with a longer hospital stay. Using a low-cost, effective nutritional screening tool for older cancer patients will enable specialized nutritional interventions and avoid inequities in the quality of cancer care worldwide.
Literature
1.
go back to reference Maasberg S, Knappe-Drzikova B, Vonderbeck D, et al. Malnutrition predicts clinical outcome in patients with neuroendocrine neoplasias. Neuroendocrinology. 2017; 104:11–25.CrossRef Maasberg S, Knappe-Drzikova B, Vonderbeck D, et al. Malnutrition predicts clinical outcome in patients with neuroendocrine neoplasias. Neuroendocrinology. 2017; 104:11–25.CrossRef
2.
go back to reference Attar A, Malka D, Sabate JM, et al. Malnutrition is high and underestimated during chemotherapy in gastrointestinal cancer: an AGEO prospective cross-sectional multicenter study. Nutr Cancer. 2012; 64:535–542.CrossRef Attar A, Malka D, Sabate JM, et al. Malnutrition is high and underestimated during chemotherapy in gastrointestinal cancer: an AGEO prospective cross-sectional multicenter study. Nutr Cancer. 2012; 64:535–542.CrossRef
3.
go back to reference Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014; 38:196–204.CrossRef Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014; 38:196–204.CrossRef
4.
go back to reference Pressoir M, Desne S, Berchery D, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010; 102:966–971.CrossRef Pressoir M, Desne S, Berchery D, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010; 102:966–971.CrossRef
5.
go back to reference Planas M, Alvarez-Hernandez J, Leon-Sanz M, Celaya-Perez S, Araujo K, Garcia de Lorenzo A; PREDyCES® researchers. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer. 2016; 24:429–435.CrossRef Planas M, Alvarez-Hernandez J, Leon-Sanz M, Celaya-Perez S, Araujo K, Garcia de Lorenzo A; PREDyCES® researchers. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer. 2016; 24:429–435.CrossRef
6.
go back to reference Silva FRM, de Oliveira MGOA, Souza ASR, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: a cross-sectional study. Nutr J. 2015; 14:123.CrossRef Silva FRM, de Oliveira MGOA, Souza ASR, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: a cross-sectional study. Nutr J. 2015; 14:123.CrossRef
7.
go back to reference Argiles JM. Cancer-associated malnutrition. Eur J Oncol Nurs 2005; 9(Suppl. 2): S39–50.CrossRef Argiles JM. Cancer-associated malnutrition. Eur J Oncol Nurs 2005; 9(Suppl. 2): S39–50.CrossRef
8.
go back to reference de Pinho NB, Martucci RB, Rodrigues VD, et al. Malnutrition associated with nutrition impact symptoms and localization of the disease: Results of a multicentric research on oncological nutrition. Clin Nutr. 2018; 19(18):30183–30181 [Epub ahead of print]. de Pinho NB, Martucci RB, Rodrigues VD, et al. Malnutrition associated with nutrition impact symptoms and localization of the disease: Results of a multicentric research on oncological nutrition. Clin Nutr. 2018; 19(18):30183–30181 [Epub ahead of print].
9.
go back to reference World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: World Health Organization; 1995. (Technical Report Series, 854). World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: World Health Organization; 1995. (Technical Report Series, 854).
10.
go back to reference Busnello FM. Aspectos nutricionais no processo do envelhecimento. São Paulo: Atheneu, 2007, p. 3–99. Busnello FM. Aspectos nutricionais no processo do envelhecimento. São Paulo: Atheneu, 2007, p. 3–99.
11.
go back to reference Huhmann MB, August DA. Review of American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Guidelines for Nutrition Support in Cancer Patients: Nutrition Screening and Assessment. Nutr Clin Pract. 2008; 23(2):182–188.CrossRef Huhmann MB, August DA. Review of American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Guidelines for Nutrition Support in Cancer Patients: Nutrition Screening and Assessment. Nutr Clin Pract. 2008; 23(2):182–188.CrossRef
12.
go back to reference Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. 2017; 36:11–48. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. 2017; 36:11–48.
13.
go back to reference Vellas B, Villars H, Abellan G, et al. Overview of the MNA—Its history and challenges. J Nutr Health Aging. 2006 Nov–Dec;10(6):456–63; discussion 463–5.PubMed Vellas B, Villars H, Abellan G, et al. Overview of the MNA—Its history and challenges. J Nutr Health Aging. 2006 Nov–Dec;10(6):456–63; discussion 463–5.PubMed
14.
go back to reference Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition. 2001; 17(7–8):573–580.CrossRef Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition. 2001; 17(7–8):573–580.CrossRef
16.
go back to reference Machado R S, Coelho M A, Veras R P. Validity of the portuguese version of the mini nutritional assessment in Brazilian elderly. BMC Geriatr. 2015; 15:132–139.CrossRef Machado R S, Coelho M A, Veras R P. Validity of the portuguese version of the mini nutritional assessment in Brazilian elderly. BMC Geriatr. 2015; 15:132–139.CrossRef
17.
go back to reference Rezende FAC, Ribeiro AQ, Priore SE, Franceschini SCC. Anthropometric differences related to genders and age in the elderly. Nutr Hosp. 2015; 32:757–764. Rezende FAC, Ribeiro AQ, Priore SE, Franceschini SCC. Anthropometric differences related to genders and age in the elderly. Nutr Hosp. 2015; 32:757–764.
18.
go back to reference Kaiser M J, Bauer J M, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009; 13:782–788.CrossRef Kaiser M J, Bauer J M, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009; 13:782–788.CrossRef
19.
go back to reference Ye XJ, Ji YB, Ma BW, et al. Comparison of three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition among patients with geriatric gastrointestinal cancer: a prospective study in China. BMJ Open. 2018;12;8(4):e019750.CrossRef Ye XJ, Ji YB, Ma BW, et al. Comparison of three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition among patients with geriatric gastrointestinal cancer: a prospective study in China. BMJ Open. 2018;12;8(4):e019750.CrossRef
20.
go back to reference Isenring E, Elia M. Which screening method is appropriate for older cancer patients at risk for malnutrition? Nutrition. 2015; 31(4): 594–597.CrossRef Isenring E, Elia M. Which screening method is appropriate for older cancer patients at risk for malnutrition? Nutrition. 2015; 31(4): 594–597.CrossRef
21.
go back to reference Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010; 13(1):46–51.CrossRef Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010; 13(1):46–51.CrossRef
23.
go back to reference Robinson MK, Mogensen KM, Casey JD, et al. The relationship among obesity, nutritional status, and mortality in the critically ill. Crit Care Med. 2015; 43(1):87–100.CrossRef Robinson MK, Mogensen KM, Casey JD, et al. The relationship among obesity, nutritional status, and mortality in the critically ill. Crit Care Med. 2015; 43(1):87–100.CrossRef
24.
go back to reference White JV, Guenter P, Jensen G, et al. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet. 2012; 112(5):730–738.CrossRef White JV, Guenter P, Jensen G, et al. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet. 2012; 112(5):730–738.CrossRef
25.
go back to reference Martin L, Watanabe S, Fainsinger R, et al. Prognostic factors in patients with advanced cancer: use of the patient-generated subjective global assessment in survival prediction. J Clin Oncol. 2010; 28(28):4376–4383.CrossRef Martin L, Watanabe S, Fainsinger R, et al. Prognostic factors in patients with advanced cancer: use of the patient-generated subjective global assessment in survival prediction. J Clin Oncol. 2010; 28(28):4376–4383.CrossRef
26.
go back to reference Hofer F, Koining KA, Nagl L, Borjan B, Stauder R. Fatigue at baseline is associated with geriatric impairments and represents an adverse prognostic factor in older patients with a hematological malignancy. Ann Hematol. 2018; 97(11):2235–2243.CrossRef Hofer F, Koining KA, Nagl L, Borjan B, Stauder R. Fatigue at baseline is associated with geriatric impairments and represents an adverse prognostic factor in older patients with a hematological malignancy. Ann Hematol. 2018; 97(11):2235–2243.CrossRef
28.
go back to reference Lilam M, and Kelaiditi E, Cesari M, et al. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013. J Nutr Health Aging. 2015; 19(5):570–4. doi: https://doi.org/10.1007/s12603-015-0457-4. Lilam M, and Kelaiditi E, Cesari M, et al. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013. J Nutr Health Aging. 2015; 19(5):570–4. doi: https://​doi.​org/​10.​1007/​s12603-015-0457-4.​
29.
go back to reference Soto-Perez-de-Celis E, de Glas NA, Hsu T, et al. Global geriatric oncology: Achievements and challenges. J Geriatr Oncol. 2017; 8(5):374–386.CrossRef Soto-Perez-de-Celis E, de Glas NA, Hsu T, et al. Global geriatric oncology: Achievements and challenges. J Geriatr Oncol. 2017; 8(5):374–386.CrossRef
Metadata
Title
Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter and Multiregional Study
Authors
Cristiane A. D’Almeida
W. A. F. Peres
N. B. de Pinho
R. B. Martucci
V. D. Rodrigues
A. Ramalho
Publication date
01-02-2020
Publisher
Springer Paris
Keyword
Malnutrition
Published in
The journal of nutrition, health & aging / Issue 2/2020
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-020-1309-4

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