Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia

Li, Ji; Wang, Chang; Liu, Xiaoliang; Liu, Qiuju; Lin, Hai; Liu, Chunshui; Jin, Fengyan; Yang, Yan; Bai, Ou; Tan, Yehui; Gao, Sujun; Li, Wei

doi:10.1097/md.0000000000009663

Cited by 18 publications

(16 citation statements)

References 32 publications

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“…Essa amplitude de valores pode ser justificada pelos diferentes tipos de câncer hematológicos compreendidos em tais amostras. Já em estudos que avaliaram somente pacientes com leucemia aguda, foram verificadas menores prevalências e com menores variações, na ordem de 15% a 27,9% 7,21 .…”

Section: Discussionunclassified

“…Corroborando estes resultados, um estudo desenvolvido no Brasil por Pinho et al 29 , com 4.783 pacientes com diferentes tipos de câncer, mostrou que há maior risco de indivíduos mais velhos apresentarem desnutrição (OR: 1,83; IC: 1,59-2,11), também avaliada por meio da ASG-PPP 29 . Já um estudo com 68 pacientes com leucemia aguda mostrou que indivíduos com mais de 60 anos estão associados com desnutrição grave 21 .…”

Section: Discussionunclassified

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Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

Silva

Oliveira²

2020

Rev. Brasileira.De.Cancerologia

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Introdução: O estado nutricional em fase pré-tratamento pode estar relacionado a desfechos clínicos desfavoráveis em pacientes com câncer. Objetivo: Avaliar o estado nutricional de pacientes adultos e idosos com leucemia em fase de pré-tratamento oncológico. Método: Trata-se de um estudo transversal, retrospectivo, envolvendo pacientes com leucemia em fase pré-tratamento oncológico. Os critérios de inclusão foram ≥20 anos de idade; ambos os sexos; e matricula no Instituto Nacional de Câncer Jose Alencar Gomes da Silva (INCA). Os critérios de exclusão foram não ter diagnostico confirmado de leucemia; registro de avaliação do estado nutricional por meio da avaliação subjetiva global produzida pelo paciente; e não ter recebido tratamento oncológico prévio. Os testes qui-quadrado e t de Student foram utilizados. Resultados: Foram avaliados 69 pacientes com leucemia em fase pré-tratamento oncológico, sendo em sua maioria homens (52,2%) com menos de 60 anos de idade (52,2%). A prevalência de desnutrição foi de 65,2%, sendo mais expressiva nos idosos (78,8%, p=0,023). A prevalência de risco nutricional apresentou a mesma frequência (65,2%), no entanto, foi maior em pacientes com comorbidades (80,8%, p=0,017) e historia de tabagismo (90,9%, p=0,056). Conclusão: A maior parte dos pacientes com leucemia iniciou seu tratamento oncológico com o estado nutricional debilitado, o que se exacerbou entre aqueles com leucemia crônica, idosos, com comorbidades e historia de tabagismo.

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Section: Discussionunclassified

Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

Silva

Oliveira²

2020

Rev. Brasileira.De.Cancerologia

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“…Although the results of some other studies show that malnutrition is associated with a lower Karnofsky score, none of them pointed the Karnofsky score as a risk factor for malnutrition. [55][56][57] In these studies a low Karnofsky score could be a consequence, rather than a cause of malnutrition.…”

Section: Risk Factors For Malnutritionon During Hospitalizationmentioning

confidence: 91%

Risk factors for malnutrition among hospitalized gastroenterological patients

et al. 2022

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Background / Aims. Risk factors for malnutrition of patients during hospitalization have not been precisely determined. The aim of the study was to determine these factors in hospitalized gastroenterological patients. Methods. Nutritional status (NS) of 650 gastroenterological patients was assessed on admission and at discharge by the six parameters: unintentional weight loss, lymphocyte counts, serum albumin concentration, body mass index, triceps skinfold thickness and midupper arm muscle circumference. The influence on NS at discharge was tested for ten factors: gender, age, affected organ, the nature, severity and complications of the disease, the lenght of hospitalization, mobility worsening during hospitalization, Karnofsky score and NS on admission. Primary and secondary risk factors were defined among the factors influencing significantly the malnutrition. Results. Seven factors were found to be the independent predictors for malnutrition in hospitalized gastroenterological patients. NS on admission was considered as primary risk factor (Forwald: Wald multivariate logistic regression analysis, p<0.001 for five applied assessment parameters). The other factors, obtained in the evaluation according to 1-3 parameters, were considered as secondary risk factors: severe disease activity, malignancy, the existence of complications, male gender, hospitalization >14 days, and mobility worsening during the hospitalization (Forwald:Wald multivariate logistic regression analysis, p from 0.001 to 0.027). Conclusion. There are seven risk factors for malnutrition among gastroenterological patients during hospitalization. Timely nutritional support in these patients can prevent the development of intrahospital malnutrition and its negative influence on clinical outcome.

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“…The complete geriatric assessment (CGA) has been used in ALL and AML patients in order to better characterize differences between patients of the same age . However, to this point no CGA tool incorporates nutritional status assessment, a known prognostic factor in AML and ALL patients of all ages . Furthermore, no nutritional assessment tool (such as body mass index [BMI], weight, or subjective global assessment [SGA] questionnaires) or any of the various serum markers (albumin, pre‐albumin, and transthyretin) are consistently used in clinical practice …”

Section: Introductionmentioning

confidence: 99%

“…3,[13][14][15] However, to this point no CGA tool incorporates nutritional status assessment, a known prognostic factor in AML and ALL patients of all ages. [16][17][18] Furthermore, no nutritional assessment tool (such as body mass index [BMI], weight, or subjective global assessment [SGA] questionnaires) or any of the various serum markers (albumin, pre-albumin, and transthyretin) are consistently used in clinical practice. 18 Bioelectrical impedance analysis is a method used to estimate body composition and cell membrane integrity.…”

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confidence: 99%

The prognostic value of standardized phase angle in adults with acute leukemia: A prospective study

et al. 2020

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Standardized phase angle (SPhA) is a tool used to estimate body composition and cell membrane integrity. Standardized phase angle has been shown to predict survival in solid malignancies and hematopoietic stem cell transplant patients. We investigated the predictive value of SPhA on 60‐day mortality, overall survival (OS), and length of hospital stay (LHS) for adults with acute myelogenous and lymphoblastic leukemia (AML and ALL). Consecutive patients ≥18 years with newly diagnosed acute leukemia receiving intensive chemotherapy were enrolled. Phase angle measurements were taken on day 1 of therapy for all patients and on the day of nadir marrow for AML patients. Measurements were standardized by BMI, gender, and age to calculate the SPhA. The difference between SPhA at nadir bone marrow compared to day 1 of induction was used to calculate change in SPhA. A cutoff of 25th percentile was used to dichotomize baseline SPhA. Among 100 patients, 88% were AML, 56% were female, and mean age was 59 years. Though not statistically significant, OS by Kaplan‐Meier analysis was shorter for those below the 25th percentile SPhA compared to those above (median OS: 11.0 months vs 19.5 months; P = .09). Lower baseline SPhA was associated with increased incidence of 60‐day mortality in univariable (odds ratio [OR] = 5.25; 1.35, 20.44; P = .02) but not multivariable analysis (OR = 3.12; 0.67, 14.48; P = .15) adjusted for age, creatinine, and cytogenetics. Increased change in SPhA was associated with worse OS (hazard ratio = 1.15; 1.00,1.33; P = .05) in multivariable analysis. Standardized phase angle is a rapid, noninvasive, and objective measure that may be used to inform risk stratification.

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Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia

Abstract: Supplemental Digital Content is available in the text

Cited by 18 publications

References 32 publications

Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

Prevalência de Desnutrição em Pacientes Adultos e Idosos em Fase de Pré-Tratamento de Leucemia

Risk factors for malnutrition among hospitalized gastroenterological patients

The prognostic value of standardized phase angle in adults with acute leukemia: A prospective study

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