Undernutrition as independent predictor of early mortality in elderly cancer patients

Martucci, Renata Brum; Barbosa, Mariana; D’Almeida, Cristiane A.; Rodrigues, V.D.; Bergmann, Anke; Pinho, Nivaldo Barroso de; Thuler, Luiz Cláudio Santos

doi:10.1016/j.nut.2016.09.011

Cited by 28 publications

(28 citation statements)

References 16 publications

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“…We found no signi cant association between malnutrition and mortality. In a cohort study in Brazilian patients aged 65 years and older, the risk of death at one year was 5 times higher in malnourished patients [17]. Similar results were reported in Spain [14].…”

Section: Discussionsupporting

confidence: 78%

“…Also, high mortality rates have been reported among hospitalized older adults, ranging from 5% during hospital stay to 20%-30% within one year following hospital discharge [7]. In the literature, main risk factors for hospital mortality among older adults are age, length of stay [9,10], health conditions such as cardiovascular diseases, diabetes, stroke, cancer, and lung diseases [10], and geriatric syndromes such as fall, inappropriate drug use, malnutrition, frailty, functional impairment, and depression [10][11][12][13][14][15][16][17]. Assessing these predictors is important as some of them can be prevented through appropriate interventions.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of three-month mortality among hospitalized older adults in Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

Preprint

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Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

Preprint

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“…24,25 This CARG score is composed of 11 variables, including the patient's age, tumor type, and treatment variables; laboratory values (hemoglobin and creatinine clearance); and GA questions (falls, ability to walk 1 block, ability to take medications without assistance, decrease in social activities, and hearing). The score ranges from 0 to 19 and can be used to define a low (score, 0-5), intermediate (score, 6-9), or high risk (score, [10][11][12][13][14][15][16][17][18][19] for grade 3+ chemotherapy toxicity.…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

“…A geriatric assessment (GA) including a nutritional evaluation is recommended for evaluating older adults with cancer before the initiation of cancer therapy because nutritional concerns are commonly identified among older patients . Undernutrition, which is defined as insufficient intake of nutrients to meet the patient's energy needs, is commonly seen among patients with cancer and has been shown to be a risk factor for morbidity, mortality, and treatment intolerance . Studies have reported undernutrition in >70% of hospitalized patients with cancer and in >40% of patients seen in outpatient clinics …”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13][14][15] Undernutrition, which is defined as insufficient intake of nutrients to meet the patient's energy needs, is commonly seen among patients with cancer and has been shown to be a risk factor for morbidity, mortality, and treatment intolerance. [16][17][18] Studies have reported undernutrition in >70% of hospitalized patients with cancer and in >40% of patients seen in outpatient clinics. [19][20][21] Cancer April 15, 2020 Historically, body mass index (BMI), albumin level, and unintentional weight loss (UWL) have been used as clinical indicators of nutritional status, and they are recommended by the European Society for Clinical Nutrition and Metabolism and by the nutritional guidelines recently published by the Global Leadership Initiative on Malnutrition.…”

Section: Introductionmentioning

confidence: 99%

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Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Dotan

Tew

Mohile

et al. 2020

Cancer

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Background Nutritional status can directly affect morbidity and mortality in older adults with cancer. This study evaluated the association between pretreatment body mass index (BMI), albumin level, and unintentional weight loss (UWL) in the prior 6 months and chemotherapy toxicity among older adults with solid tumors. Methods This was a secondary analysis of a prospective, multicenter study involving chemotherapy‐treated patients 65 years old or older. Geriatric assessment, BMI, albumin level, and UWL data were collected before treatment. Multivariable logistic regression models evaluated the associations between nutritional factors and the risk of grade 3 or higher (grade 3+) chemotherapy toxicity. Results Seven hundred fifty patients with a median age of 72 years (range, 65‐94 years) and mostly stage IV disease were enrolled. The median pretreatment BMI and albumin values were 26 kg/m2 (range, 15.1‐52.1 kg/m2) and 3.9 mg/dL (range, 1.0‐5.0 mg/dL), respectively. Nearly 50% of the patients reported UWL, with 17.6% reporting >10% UWL. Multivariable analysis revealed no association between >10% UWL and a risk for grade 3+ chemotherapy toxicity (adjusted odds ratio [AOR], 0.87; P = .58). Multivariable analysis showed a trend toward an association between a BMI ≥ 30 kg/m2 and a decreased risk of grade 3+ chemotherapy toxicity (AOR, 0.65; P = .06), whereas a low albumin level (≤3.6 mg/dL) was associated with a higher risk of grade 3+ chemotherapy toxicity (AOR, 1.50; P = .03). An analysis of the joint effect of BMI and albumin demonstrated the lowest risk of grade 3+ chemotherapy toxicity among patients with high BMIs (≥30 kg/m2) and normal albumin levels (AOR, 0.41; P = .008). Conclusions Among older adults with solid tumors, higher BMIs and normal albumin levels are associated with a lower risk of grade 3+ chemotherapy toxicity. Additional research is warranted to define the clinical significance of nutritional markers and to inform future interventions.

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Prognostic impact of adipose tissue loss at 1 month after surgery in patients with gastric cancer

Hashimoto,

Komori,

Onuma

et al. 2024

World j. surg.

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BackgroundThe postoperative impact of short‐term changes in skeletal muscle loss (SML) and adipose tissue loss (ATL) on treatment outcomes is unclear in patients with gastric cancer (GC). We investigate the role of SML and ATL at 1 month after surgery in determining postoperative survival and recurrence rates in patients with GC.MethodsWe analyzed 540 patients with GC and assessed their skeletal muscle mass, visceral fat mass, and subcutaneous fat mass using computed tomography scans preoperatively and 1 month postoperatively. Patients were categorized into high and low groups based on their levels of SML, visceral ATL (v‐ATL), and subcutaneous ATL (s‐ATL). Additionally, they were classified into three groups (high ATL, intermediate ATL, and low ATL) based on their v‐ATL and s‐ATL measurements.ResultsPatients with higher v‐ATL and s‐ATL had lower overall survival (OS) and recurrence‐free survival (RFS) rates. High ATL was an independent prognostic factor for decreased OS (hazard ratio [HR] 2.27; 95% confidence interval [CI] 1.16–4.42; and P = 0.02) and RFS (HR 2.51; 95% CI 1.34–4.71; and P = 0.004) rates.ConclusionA reduction in adipose tissue volume shortly after surgery (1 month) could potentially indicate an increased risk of recurrence and mortality in patients with GC.

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Undernutrition as independent predictor of early mortality in elderly cancer patients

Cited by 28 publications

References 16 publications

Predictors of three-month mortality among hospitalized older adults in Togo

Predictors of three-month mortality among hospitalized older adults in Togo

Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors

Prognostic impact of adipose tissue loss at 1 month after surgery in patients with gastric cancer

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