The nutritional risk in oncology: a study of 1,453 cancer outpatients

Abstract

PurposeThere is little information about the nutritional status of cancer outpatients because the practice of nutritional screening is rarely performed. This study aims to define the pattern of scores of nutritional risk in 1,453 outpatients and factors associated with a high nutrition risk score, to facilitate the identification of such patients by the oncologists.MethodsWe prospectively screened the nutritional status of cancer outpatients according to the NRS-2002 score which combines indicators of malnutrition and of severity of the disease (1–3 points, respectively). A score ≥3 indicates “nutritional risk”. The association of the nutritional scores with some patient/tumour/therapy-related variables was investigated through univariable and multivariable linear regression models.ResultsThirty-two percent of outpatients were at nutritional risk. Primary tumour site, Eastern Cooperative Oncology Group score and presence of anorexia or fatigue were significantly associated with the nutrition risk score. Depending on the combination of these variables, it was possible to estimate different probabilities of nutritional risk.ConclusionsThe frequency of a relevant nutritional risk was higher than expected considering the favourably selected population. The nutritional risk was associated with common clinical variables which are usually recorded in the charts and could easily alert the oncologist on the need of a further nutritional assessment or a nutritional support.

The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

“…However, a recent study of 1453 outpatients suggests that a broader range of patients are at nutritional risk during cancer treatment (25). Despite this, nutritional screenings are not routinely conducted with cancer patients.…”

Longitudinal assessment of nutritional risk in patients under chemo or radiotherapy

“…The prevalence of compromised nutritional status in our study is consistent with results of studies by other researchers. [10][11][12][13] Based on the NRS-2002, severe nutritional risk was documented in 50% of patients before the start of cancer treatment 13 and in 76% of individuals with various types of cancers. 11 Among patients recently hospitalized with various types of cancer, the use of Patient-Generated Subjective Global Assessment protocol showed varying degrees of malnutrition in about 70% of cases.…”

“…[10][11][12][13] Based on the NRS-2002, severe nutritional risk was documented in 50% of patients before the start of cancer treatment 13 and in 76% of individuals with various types of cancers. 11 Among patients recently hospitalized with various types of cancer, the use of Patient-Generated Subjective Global Assessment protocol showed varying degrees of malnutrition in about 70% of cases. 10,12 In Australia, the risk of malnutrition was documented in 64% of patients admitted to a public hospital specializing in cancer treatment, 14 but only in 17% of cases treated in an outpatient oncology unit.…”

“…8 The inclusion of nutrition professionals in oncology services will allow early nutritional guidance, including nutritional therapy, if necessary. 11 The diet's nutritional value, feeding frequency, and consistency of the food can affect the severity of gastrointestinal symptoms and cause negative impact on food intake, nutritional status, and quality of life. 16 For example, patients can be instructed to drink pasty or liquid foods, eating fractionated meals and in small volumes, 16 or to fortify their diet and use nutritional supplements orally.…”

Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – A multicentre cohort study

“…Though not frequently included in a GA [6], nutritional status (NS) is one of the geriatric domains that is frequently impaired in onco-geriatric patients [7][8][9]. Recent studies on middle-aged and elderly cancer patients, reported high numbers of patients at nutritional risk or being malnourished (32% to 64.2%) [7][8][9].…”