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Published in: Supportive Care in Cancer 3/2005

01-03-2005 | Original Article

Nutritional status of cancer patients and its relationship to function in an inpatient rehabilitation setting

Authors: Ying Guo, J. Lynn Palmer, Guddi Kaur, Susan Hainley, Beth Young, Eduardo Bruera

Published in: Supportive Care in Cancer | Issue 3/2005

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Abstract

Background

Malnutrition is associated with prolonged hospitalization, lower survival rate, and various medical complications. However, little is known about malnutrition and its relationship with the functional status. We undertook this retrospective study to examine whether or not malnutrition affects rehabilitation outcome in patients who had undergone cancer rehabilitation.

Methods

We conducted a review of the charts of 30 consecutive cancer patients who had been admitted to the inpatient rehabilitation unit in a tertiary cancer center, from the beginning of March 2001 to the end of April 2001.

Results

The patients’ mean rehabilitation stay was 9 days and their mean age was 58 years (range 22–86 years). On rehabilitation admission, 15 of the patients (50%) had a below normal prealbumin (<18 mg/dl) level (95% confidence interval 31–69%), and on discharge 10 of the patients (33%) had a below normal prealbumin level (95% CI 17–54%). The serum prealbumin concentration level correlated with motor functional independence measure scores on admission. After inpatient rehabilitation, statistically significant gains in functional independence measure scores (P<0.0001) were obtained in patients with below normal admission prealbumin, as well as in those whose prealbumin levels were within the normal range; no statistically significant difference was found in functional gain between these two groups.

Conclusion

Our study showed that a large number of cancer rehabilitation patients had malnutrition. Nevertheless, functional gain was achieved in all patients after rehabilitation, whether or not malnutrition was present. We conclude that malnourished patients should still be considered candidates for rehabilitation.
Literature
1.
go back to reference Aisner J, Hiponia D, Conley B, et al (1995) Combined modalities in the treatment of head and neck cancers. Semin Oncol 22 [3 Suppl 6]:28–34 Aisner J, Hiponia D, Conley B, et al (1995) Combined modalities in the treatment of head and neck cancers. Semin Oncol 22 [3 Suppl 6]:28–34
2.
go back to reference Ardies CM (2002) Exercise, cachexia, and cancer therapy: a molecular rationale. Nutr Cancer 42:143–157CrossRefPubMed Ardies CM (2002) Exercise, cachexia, and cancer therapy: a molecular rationale. Nutr Cancer 42:143–157CrossRefPubMed
3.
go back to reference Beck FK, Rosenthal TC (2002) Pre-albumin: a marker for nutritional evaluation. Am Fam Physician 65:1575–1578PubMed Beck FK, Rosenthal TC (2002) Pre-albumin: a marker for nutritional evaluation. Am Fam Physician 65:1575–1578PubMed
5.
go back to reference Breitbart W, Rosenfeld B, Pessin H, et al (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284:2907–2911CrossRefPubMed Breitbart W, Rosenfeld B, Pessin H, et al (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284:2907–2911CrossRefPubMed
6.
go back to reference Briassoulis G, Zavras N, Hatzis T (2001) Malnutrition, nutritional indices, and early enteral feeding in critically ill children. Nutrition 17:548–557CrossRefPubMed Briassoulis G, Zavras N, Hatzis T (2001) Malnutrition, nutritional indices, and early enteral feeding in critically ill children. Nutrition 17:548–557CrossRefPubMed
8.
go back to reference Cozzaglio L, Balzola F, Cosentino F, et al (1997) Outcome of cancer patients receiving home parenteral nutrition. Italian Society of Parenteral and Enteral Nutrition (SINPE). JPEN J Parenter Enteral Nutr 21:339–342PubMed Cozzaglio L, Balzola F, Cosentino F, et al (1997) Outcome of cancer patients receiving home parenteral nutrition. Italian Society of Parenteral and Enteral Nutrition (SINPE). JPEN J Parenter Enteral Nutr 21:339–342PubMed
9.
go back to reference Crogan NL, Pasvogel A (2003) The influence of protein-calorie malnutrition on quality of life in nursing homes. J Gerontol A Biol Sci Med Sci 58:159–164PubMed Crogan NL, Pasvogel A (2003) The influence of protein-calorie malnutrition on quality of life in nursing homes. J Gerontol A Biol Sci Med Sci 58:159–164PubMed
10.
go back to reference Elhasid R, Laor A, Lischinsky S, et al (1999) Nutritional status of children with solid tumors. Cancer 86:119–125CrossRefPubMed Elhasid R, Laor A, Lischinsky S, et al (1999) Nutritional status of children with solid tumors. Cancer 86:119–125CrossRefPubMed
11.
go back to reference Granger CV (1998) The emerging science of functional assessment: our tool for outcomes analysis. Arch Phys Med Rehabil 79:235–240CrossRefPubMed Granger CV (1998) The emerging science of functional assessment: our tool for outcomes analysis. Arch Phys Med Rehabil 79:235–240CrossRefPubMed
12.
go back to reference Hamilton BB, Laughlin JA, Granger CV, et al (1991) Interrater agreement of the seven level Functional Independence Measure (FIM). Arch Phys Med Rehabil 71:790 Hamilton BB, Laughlin JA, Granger CV, et al (1991) Interrater agreement of the seven level Functional Independence Measure (FIM). Arch Phys Med Rehabil 71:790
13.
go back to reference Hamilton BB, Deutsch A, Russell C, et al (1999) Relation of disability costs to function: spinal cord injury. Arch Phys Med Rehabil 80:385–391CrossRefPubMed Hamilton BB, Deutsch A, Russell C, et al (1999) Relation of disability costs to function: spinal cord injury. Arch Phys Med Rehabil 80:385–391CrossRefPubMed
14.
go back to reference Humphreys J, de la Maza P, Hirsch S, et al (2002) Muscle strength as a predictor of loss of functional status in hospitalized patients. Nutrition 18:616–620CrossRefPubMed Humphreys J, de la Maza P, Hirsch S, et al (2002) Muscle strength as a predictor of loss of functional status in hospitalized patients. Nutrition 18:616–620CrossRefPubMed
15.
go back to reference Karnofsky DA, Abelmann WH, Craver LF, et al (1948) The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1:634–656 Karnofsky DA, Abelmann WH, Craver LF, et al (1948) The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1:634–656
16.
go back to reference Keith RA, Granger CV, Hamilton BB, et al (1987) The Functional Independence Measure: a new tool for rehabilitation. In: Eisenberg MG, Grzesiak RC (eds) Advances in clinical rehabilitation. Springer, New York, pp 6–18 Keith RA, Granger CV, Hamilton BB, et al (1987) The Functional Independence Measure: a new tool for rehabilitation. In: Eisenberg MG, Grzesiak RC (eds) Advances in clinical rehabilitation. Springer, New York, pp 6–18
17.
go back to reference Kidd D, Stewart G, Baldry J, et al (1995) The Functional Independence Measure: a comparative validity and reliability study. Disabil Rehabil 17:10–14PubMed Kidd D, Stewart G, Baldry J, et al (1995) The Functional Independence Measure: a comparative validity and reliability study. Disabil Rehabil 17:10–14PubMed
18.
go back to reference Kretser AJ, Voss T, Kerr WW, et al (2003) Effects of two models of nutritional intervention on homebound older adults at nutritional risk. J Am Diet Assoc 103:329–336CrossRefPubMed Kretser AJ, Voss T, Kerr WW, et al (2003) Effects of two models of nutritional intervention on homebound older adults at nutritional risk. J Am Diet Assoc 103:329–336CrossRefPubMed
19.
go back to reference Kurugol Z, Egemen A, Cetingul N, et al (1997) Early determination of nutritional problems in pediatric cancer patients. Turk J Pediatr 39:325–334PubMed Kurugol Z, Egemen A, Cetingul N, et al (1997) Early determination of nutritional problems in pediatric cancer patients. Turk J Pediatr 39:325–334PubMed
20.
go back to reference Lai SL, Perng RP (1998) Impact of nutritional status on the survival of lung cancer patients. Chin Med J (Engl) 61:134–140 Lai SL, Perng RP (1998) Impact of nutritional status on the survival of lung cancer patients. Chin Med J (Engl) 61:134–140
21.
go back to reference Mears E (1996) Outcomes of continuous process improvement of a nutritional care program incorporating serum pre-albumin measurements. Nutrition 12:479–484CrossRefPubMed Mears E (1996) Outcomes of continuous process improvement of a nutritional care program incorporating serum pre-albumin measurements. Nutrition 12:479–484CrossRefPubMed
22.
go back to reference Mittman N, Avram MM, Oo KK, et al (2001) Serum pre-albumin predicts survival in hemodialysis and peritoneal dialysis: 10 years of prospective observation. Am J Kidney Dis 38:1358–1364PubMed Mittman N, Avram MM, Oo KK, et al (2001) Serum pre-albumin predicts survival in hemodialysis and peritoneal dialysis: 10 years of prospective observation. Am J Kidney Dis 38:1358–1364PubMed
23.
go back to reference Nelson ME, Layne JE, Bernstein MJ, et al (2004) The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol A Biol Sci Med Sci 59:154–160PubMed Nelson ME, Layne JE, Bernstein MJ, et al (2004) The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol A Biol Sci Med Sci 59:154–160PubMed
24.
go back to reference Nucci M, Anaissie EJ, Queiroz-Telles F, et al (2003) Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 98:315–319CrossRefPubMed Nucci M, Anaissie EJ, Queiroz-Telles F, et al (2003) Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 98:315–319CrossRefPubMed
25.
go back to reference Ollenschlager G, Viell B, Thomas W, et al (1991) Tumor anorexia: causes, assessment, treatment. Recent Results Cancer Res 121:249–259PubMed Ollenschlager G, Viell B, Thomas W, et al (1991) Tumor anorexia: causes, assessment, treatment. Recent Results Cancer Res 121:249–259PubMed
26.
go back to reference Ottery FD (1995) Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol 22 [2 Suppl 3]:98–111 Ottery FD (1995) Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol 22 [2 Suppl 3]:98–111
27.
go back to reference Pallicino P, Snyder W, Granger C (1992) The NIH Stroke Scale and the FIM in stroke rehabilitation. Stroke 23:919 Pallicino P, Snyder W, Granger C (1992) The NIH Stroke Scale and the FIM in stroke rehabilitation. Stroke 23:919
28.
go back to reference Payette H, Boutier V, Coulombe C, et al (2002) Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. J Am Diet Assoc 102:1088–1095CrossRefPubMed Payette H, Boutier V, Coulombe C, et al (2002) Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. J Am Diet Assoc 102:1088–1095CrossRefPubMed
29.
go back to reference Potter MA, Luxton G (1999) Pre-albumin measurement as a screening tool for protein calorie malnutrition in emergency hospital admissions: a pilot study. Clin Invest Med 22:44–52PubMed Potter MA, Luxton G (1999) Pre-albumin measurement as a screening tool for protein calorie malnutrition in emergency hospital admissions: a pilot study. Clin Invest Med 22:44–52PubMed
30.
go back to reference Sabers SR, Kokal JE, Girardi JC, et al (1999) Evaluation of consultation-based rehabilitation for hospitalized cancer patients with functional impairment. Mayo Clinic Proc 74:855–861 Sabers SR, Kokal JE, Girardi JC, et al (1999) Evaluation of consultation-based rehabilitation for hospitalized cancer patients with functional impairment. Mayo Clinic Proc 74:855–861
31.
go back to reference Scott C, Sause WT, Byhardt R, et al (1997) Recursive partitioning analysis of 1592 patients on four Radiation Therapy Oncology Group studies in inoperable non-small cell lung cancer. Lung Cancer 17 [Suppl 1]:S59–74 Scott C, Sause WT, Byhardt R, et al (1997) Recursive partitioning analysis of 1592 patients on four Radiation Therapy Oncology Group studies in inoperable non-small cell lung cancer. Lung Cancer 17 [Suppl 1]:S59–74
32.
go back to reference Smale BF, Mullen JL, Buzby GP, et al (1981) The efficacy of nutritional assessment and support in cancer surgery. Cancer 47:2375–2381PubMed Smale BF, Mullen JL, Buzby GP, et al (1981) The efficacy of nutritional assessment and support in cancer surgery. Cancer 47:2375–2381PubMed
33.
go back to reference Stafford RS, Cyr PL (1997) The impact of cancer on the physical function of the elderly and their utilization of health care. Cancer 80:1973–1980CrossRefPubMed Stafford RS, Cyr PL (1997) The impact of cancer on the physical function of the elderly and their utilization of health care. Cancer 80:1973–1980CrossRefPubMed
34.
go back to reference Stineman MG, Fiedler RC, Granger CV, et al (1998) Functional task benchmarks for stroke rehabilitation. Arch Phys Med Rehabil 79:497–504CrossRefPubMed Stineman MG, Fiedler RC, Granger CV, et al (1998) Functional task benchmarks for stroke rehabilitation. Arch Phys Med Rehabil 79:497–504CrossRefPubMed
35.
go back to reference Strasser F, Bruera ED (2002) Update on anorexia and cachexia. Hematol Oncol Clin North Am 16:589–617PubMed Strasser F, Bruera ED (2002) Update on anorexia and cachexia. Hematol Oncol Clin North Am 16:589–617PubMed
36.
go back to reference Tchekmedyian NS (1999) Nutritional support and quality of life. In: Heber D, Blackburn GL, Go VLW, et al (eds) Nutritional oncology. Academic Press, San Diego, pp 587–592 Tchekmedyian NS (1999) Nutritional support and quality of life. In: Heber D, Blackburn GL, Go VLW, et al (eds) Nutritional oncology. Academic Press, San Diego, pp 587–592
37.
go back to reference Thiel HJ, Fietkau R, Sauer R (1988) Malnutrition and the role of nutritional support for radiation therapy patients. Recent Results Cancer Res 108:205–226PubMed Thiel HJ, Fietkau R, Sauer R (1988) Malnutrition and the role of nutritional support for radiation therapy patients. Recent Results Cancer Res 108:205–226PubMed
39.
go back to reference Wouters-Wesseling W, Van Hooijdonk C, Wagenaar L, et al (2003) The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people. Clin Nutr 22:371–377CrossRefPubMed Wouters-Wesseling W, Van Hooijdonk C, Wagenaar L, et al (2003) The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people. Clin Nutr 22:371–377CrossRefPubMed
40.
go back to reference Yoshioka H (1994) Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 73:199–206PubMed Yoshioka H (1994) Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 73:199–206PubMed
41.
go back to reference Zogbaum AT (1996) Enteral feedings are associated with improved adherence to radiation treatment prescription and weight maintenance in head and neck cancer patients (abstract). J Am Diet Assoc 96:A-35 Zogbaum AT (1996) Enteral feedings are associated with improved adherence to radiation treatment prescription and weight maintenance in head and neck cancer patients (abstract). J Am Diet Assoc 96:A-35
Metadata
Title
Nutritional status of cancer patients and its relationship to function in an inpatient rehabilitation setting
Authors
Ying Guo
J. Lynn Palmer
Guddi Kaur
Susan Hainley
Beth Young
Eduardo Bruera
Publication date
01-03-2005
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 3/2005
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-004-0680-8

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