Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres

Abstract

Background:This epidemiological observational study aimed at determining the prevalence of malnutrition in non-selected adults with cancer, to identify risk factors of malnutrition and correlate the results with length of stay and 2-month mortality.Methods:This prospective multicentre 1-day study conducted in 17 French Comprehensive Cancer Centres included 1545 patients. Body mass index (BMI), weight loss (WL) in the past 6 months and age were routinely recorded according to the French national recommendations for hospitalised patients; malnutrition was rated as absent, moderate or severe according to the level of WL and BMI. Age, sex, tumour site, type of hospitalisation and treatment, disease stage, World Health Organisation performance status (PS) and antibiotic therapy were the potential malnutrition risk factors tested. Follow-up at 2 months allowed to determine the correlation with length of stay and mortality.Results:Malnutrition was reported in 30.9% of patients, and was rated as severe in 12.2%. In multivariate analysis, only pre-existing obesity (BMI⩾30), PS ⩾2 and head-and-neck or upper digestive cancers were associated with increased risk of malnutrition. Antibiotics use was significantly higher in malnourished patients (35.5 vs 22.8% P<0.001). Severe malnutrition was independently associated with mortality. The median length of stay was 19.3±19.4 days for malnourished patients vs 13.3±19.4 days for others (P<0.0001).Conclusion:In French Comprehensive Cancer Centres, one out of three cancer patients are malnourished and this was associated with a longer length of stay. Pre-existing obesity could be identified as a new risk factor for malnutrition in our cancer patient population perhaps because of a misidentification or a delay in nutrition support in this category of patients.

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

“…The prevalence of nutritional risk in hospitalized patients with cancer in our study was higher than that reported in those studies in European and American hospitals by using the same parameters. 3,6,[18][19][20][21][22][23][24][25][26][27][28][29] It indicates that compared with cancer patients from European and American countries, there is a higher proportion of Chinese cancer patients at nutritional risk and with nutritional deficiencies at admission and during hospitalization. The possible reasons for this difference include: (1) compared with cancer patients in Western countries, the Chinese patients has relatively lower body weight and poor nutritional status at admission, and (2) relatively fewer doctors in Chinese hospitals can identify cancer patients at nutritional risk early in order to plan Nutritional risk, clinical outcome and quality of life in cancer patients K Yu et al the best possible intervention, which make the patients' nutritional status tended to worsen during the hospitalization.…”

Computed tomography diagnosed cachexia and sarcopenia in 725 oncology patients: is nutritional screening capturing hidden malnutrition?

“…The rate of malnutrition can vary greatly depending on tumour site and stage; however, it is estimated to affect between 8% and 85% of cancer patients 1, 2, 3, 4. Identification of malnutrition is critical as it negatively impacts on prognosis and has been associated with a range of adverse clinical outcomes 5, 6, 7, 8, 9, 10, 11, 12, 13. Severe malnutrition is independently associated with mortality, with an estimated 20–30% of cancer deaths attributable to malnutrition 14, 15.…”

Severe weight loss in 3 months after allogeneic hematopoietic SCT was associated with an increased risk of subsequent non-relapse mortality

“…Nutritional screening to identify patients at risk is important because early intervention is necessary in order to improve the outcome by nutritional support. Although malnutrition in general negatively influences prognosis, [14][15][16][17] the impact of weight loss after allogeneic HSCT on the subsequent clinical outcome has not yet been assessed. In this study, we aimed to determine the prevalence of weight loss and assess the impact of weight loss on the clinical outcome after allogeneic HSCT.…”