A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer

Abstract

BACKGROUND/OBJECTIVES: To implement nutritional risk screening and evaluate the relationship of nutritional risk to complication rate and quality of life in patients with cancer. SUBJECTS/METHODS: A total of 687 patients with cancer from two teaching hospitals in China were consecutively enrolled. Data were collected on the nutritional risk screening, application of nutritional support, complication and quality of life. RESULTS: The prevalence of nutritional risk at admission among the total, younger and elderly patients was 45.6%, 38.7% and 58.0%, respectively. There was a significant increase in the prevalence from admission to 2 weeks after admission in all patients (P ¼ 0.011). The prevalence in those patients X70 years was significantly higher than that in the younger ones (Po0.001). The highest prevalence of nutritional risk was in pancreas cancer (81.8%). Only 46.7% of at-risk patients received nutritional support and the average PN:EN ratio was 7.0:1. Complications were noted in 29.0% of all patients and were significantly more frequent in 'at-risk' patients (Po0.001). Among the scales of quality of life (SF-36), the scores of physical functioning (Po0.001), role-physical (Po0.001), bodily pain (P ¼ 0.012), energy/fatigue (Po0.001) and general health (Po0.001) were significant lower in the patients at risk. CONCLUSIONS: A large proportion of cancer inpatients were at nutritional risk and tended to worsen during the course of admission, which has been associated with increased complication rate and lower scores of quality of life. The application of PN and EN was inappropriate in patients with cancer in China.

Nutrition Indicators, Physical Function, and Health-Related Quality of Life in Breast Cancer Patients

“…Nonetheless, treatment-related side effects on nutritional status such as nausea and vomiting, appetite loss and diarrhea, which negatively affect patients' functional status and HRQoL (Dang et al, 2016) are commonly reported. While mounting evidence shows malnutrition is associated with decreasing HRQoL in cancer patients (Lis et al, 2012;Yu et al, 2013), the relationship between nutritional status and HRQoL is under-studied for breast cancer patients, who are at lower risk of under-nutrition as compared to other cancers (Lis et al, 2012). In spite of the negative impact of altered taste perception on calorie intake (Boltong et al, 2014;de Vries et al, 2017), weight gain was increasingly reported for breast cancer patients even during treatment (van den Berg et al, 2017), which may decrease their physical function and overall quality of life (QoL) (Fang et al, 2013), suggesting healthy eating habit for general health maintenance among the breast cancer patients is critical.…”

Screening and application of nutritional support in elderly hospitalized patients of a tertiary care hospital in China

“…The theories and methods behind nutritional support are constantly evolving. For patients who need nutritional support, choice of the appropriate method can enhance the recovery of patients and significantly improve clinical results and prognosis [1–3]. Due to a higher nutritional risk rate and functional degeneration, patients with multiple conditions are more common among elderly patients, who are more susceptible to disease and malnutrition.…”

Investigation on nutrition status and clinical outcome of patients with common cancers in Chinese patients: a multicenter prospective study protocol

“…7,8,12,25,27 The frequent presence of malnutrition in cancer patients can limit their response to even the best therapies if nutritional issues are not appropriately managed. 30,32 Understanding baseline levels of nutritional status, physical function and quality of life is of growing importance in defining individualized supportive care plans for cancer patients. 12 In this INSCOC study, we have thus far collected more than 30,000 cases from 80 hospitals since 2013 and will recruit additional 20,000 cases in totally 100 hospitals in different regions in China in the next 3 years.…”

“…9,[24][25][26][27][28] Recently the nutrition status of cancer patients has caught the attention of Chinese surgeons, physicians and dieticians. 22,[29][30][31][32][33][34][35] It is reported that the prevalence of malnutrition ranged from 12.6% to 54%, depending on the cancer type, cancer stage, and patient age. 22,30,32,33,35 The benefits of nutritional intervention have been shown in cancer patients with malnutrition.…”

“…22,[29][30][31][32][33][34][35] It is reported that the prevalence of malnutrition ranged from 12.6% to 54%, depending on the cancer type, cancer stage, and patient age. 22,30,32,33,35 The benefits of nutritional intervention have been shown in cancer patients with malnutrition. 8,25,27 However, the sample size in the reported studies is relatively small, and most of them focus on the gastrointestinal cancer and lung cancer, not including many other frequently diagnosed cancers among men and women.…”