Nutritional Screening in a University Hospital: Comparison between Oncologic and Non-Oncologic Patients

DOI: 10.4236/fns.2015.61009   PDF   HTML   XML   3,549 Downloads   4,326 Views   Citations

Abstract

Background & Aims: We compared the screening nutritional data of patients with malignant and non-malignant disease, and classified their nutritional risk according to the primary tumor’s site. Methods: Subjective Global Assessment was applied to 3008 patients within 48 h of admission to a public university. Subjects were divided into Oncologic Group (n = 576) or Non-Oncologic Group (n = 2432) according to the presence of neoplasms or other diseases respectively. These data were compared by the t-student test and classic chi-square test, with statistical significance set at p < 0.05. Results: The Oncologic Group presented a higher prevalence of weight loss (60.3% vs. 49.3%), quantitative (40.7% vs. 28.5%) and qualitative (16.4% vs. 7.6%) alterations in the food intake pattern, gastrointestinal symptoms and muscle waste (23.2% vs. 13.2%) as compared to the Non-Oncologic Group. Also, there was a higher prevalence of nutritional disturbances in the Oncologic Group, with 49.5% of the subjects moderately (or suspected to be malnourished) and 12.7% severely mal-nourished. Severe malnourishment was mainly observed in patients with head and neck (25%), upper digestive tract (21.9%) and soft tissue and bones (17.9%) tumors. Conclusion: When compared to other hospitalized patients, patients with neoplastic disease were in higher nutritional risk.

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Cunha, S. , Tanaka, L. , Salomão, R. , Macedo, D. , Santos, T. and Peria, F. (2015) Nutritional Screening in a University Hospital: Comparison between Oncologic and Non-Oncologic Patients. Food and Nutrition Sciences, 6, 75-82. doi: 10.4236/fns.2015.61009.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Tisdale, M.J. (2002) Cachexia in Cancer Patients. Nature Reviews Cancer, 2, 862-871.
http://dx.doi.org/10.1038/nrc927
[2] Bozzetti, F., Arends, J., Lundholm, K., Micklewright, A., Zucher, G. and Muscaritoli, M. (2009) ESPEN Guidelines on Parenteral Nutrition: Non-Surgical Onconlogy. Clinical Nutrition, 28, 445-454.
http://dx.doi.org/10.1016/j.clnu.2009.04.011
[3] Huhmann, M.B. and Cunningham, R.S. (2005) Importance of Nutritional Screening in Treatment of Cancer-Related Weight Loss. Lancet Oncology, 6, 334-343.
http://dx.doi.org/10.1016/S1470-2045(05)70170-4
[4] Arends, J., Bodoky, G., Bozzetti, F., Fearon, K., Muscaritoli, M., Selga, G., van Bokhorst-de van der Schueren, M.A. and von Meyenfeldt, M., DGEM (German Society for Nutritional Medicine); Zürcher, G., Fietkau, R., Aulbert, E., Frick, B., Holm, M., Kneba, M., Mestrom, H.J. and Zander, A., ESPEN (European Society for Parenteral and Enteral Nutrition) (2006) ESPEN Guidelines on Enteral Nutrition: Non-Surgical Oncology. Clinical Nutrition, 25, 245-259.
http://dx.doi.org/10.1016/j.clnu.2006.01.020
[5] De Blaauw, I., Deutz, N.E.P. and Von Meyenfeldt, M.F. (1997) Metabolic Changes in Cancer Cachexia—First of Two Parts. Clinical Nutrition, 16, 169-176.
http://dx.doi.org/10.1016/S0261-5614(97)80002-7
[6] Aspen Board of Directors and the Clinical Guidelines Task Force (2002) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients. Journal of Parenteral and Enteral Nutrition, 26, 1SA-138SA.
[7] Borges, N.P., D’Alegria-Silva, B., Cohen, C., Portari Filho, P.E. and Medeiros, F.J. (2009) Comparison of the Nutritional Diagnosis, Obtained through Different Methods and Indicators, in Patients with Cancer. Nutricion Hospitalaria, 24, 51-55.
[8] Geirsdottir, O.G. and Thorsdottir, I. (2008) Nutritional Status of Cancer Patients in Chemotherapy, Dietary Intake, Nitrogen Balance and Screening. Food & Nutrition Research, 52.
[9] Elia, M., Zellipour, L. and Stratton, R.J. (2005) To Screen or Not to Screen for Adult Malnutrition? Clinical Nutrition, 24, 867-884.
http://dx.doi.org/10.1016/j.clnu.2005.03.004
[10] Huhmann, M.B. and August, D.A. (2008) Review of American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Guidelines for Nutrition Support in Cancer Patients: Nutrition Screening and Assessment. Nutrition in Clinical Practice, 23, 182-188.
http://dx.doi.org/10.1177/0884533608314530
[11] Raslan, M., Gonzalez, M.C., Torrinhas, R.S.M.M., Ravacci, G.R., Pereira, J.C.R. and Waitzberg, D.L. (2011) Complementarity of Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002) for Predicting Poor Clinical Outcomes in Hospitalized Patients. Clinical Nutrition, 30, 49-53.
http://dx.doi.org/10.1016/j.clnu.2010.07.002
[12] Detsky, A.S., McLaughlin, J.R., Baker, J.P., Johnston, N., Whittaker, S., Mendelson, R.A. and Jeejeebhoy, K.N. (1987) What Is Subjective Global Assessment of Nutritional Status? Journal of Parenteral and Enteral Nutrition, 11, 8-13.
http://dx.doi.org/10.1177/014860718701100108
[13] Segura, A., Pardo, J., Jara, C., Zugazabeitia, L., Carulla, J., de Las Penas, R., García-Cabrera, E., Luz Azuara, M., Casadó, J. and Gómez-Candela, C. (2005) An Epidemiological Evaluation of the Prevalence of Malnutrition in Spanish Patients with Locally Advanced or Metastatic Cancer. Clinical Nutrition, 24, 801-814.
http://dx.doi.org/10.1016/j.clnu.2005.05.001
[14] Sarhill, N., Mahmoud, F., Walsh, D., Nelson, K.A., Komurcu, S., Davis, M., LeGrand, S., Abdullah, O. and Rybicki, L. (2003) Evaluation of Nutritional Status in Advanced Metastatic Cancer. Supportive Care in Cancer, 11, 652-659.
http://dx.doi.org/10.1007/s00520-003-0486-0
[15] Bovio, G., Montagna, G., Bariani, C. and Baiardi, P. (2009) Upper Gastrointestinal Symptoms in Patients with Advanced Cancer: Relationship to Nutritional and Performance Status. Supportive Care in Cancer, 17, 1317-1324.
http://dx.doi.org/10.1007/s00520-009-0590-x
[16] Gómez-Candela, C., Luengo, L.M., Cos, A.I., Martínez-Roque, V., Iglesias, C., Zamora, P. and González-Barón, R. (2003) Subjective Global Assessment in Neoplastic Patients [Valoración Global Subjetiva en el Paciente Neoplásico]. Nutrición Hospitalaria, 18, 353-357.
[17] Cid Conde, L., Fernández López, T., Neira Blanco, P., Arias Delgado, J., Varela Correa, J.J. and Gómez Lorenzo, F.F. (2008) Hyponutrition Prevalence among Patients with Digestive Neoplasm before Surgery [Prevalencia de Desnutrición em Pacientes com Neoplasia Digestiva Previa Cirurgia]. Nutrición Hospitalaria, 23, 46-53.
[18] von Meyenfeldt, M. (2005) Cancer-Associated Malnutrition: An Introduction. European Journal of Oncology Nursing, 9, 35-38.
http://dx.doi.org/10.1016/j.ejon.2005.09.001
[19] Khal, J., Hine, A.V., Fearon, K.C., Dejong, C.H. and Tisdale, M.J. (2005) Increased Expression of Proteasome Subunits in Skeletal Muscle of Cancer Patients with Weight Loss. International Journal of Biochemistry & Cell Biology, 37, 2196-2206.
http://dx.doi.org/10.1016/j.biocel.2004.10.017
[20] Fang, S., Long, J., Tan, R., Mai, H., Lu, W., Yan, F. and Peng, J. (2013) A Multicentre Assessment of Malnutrition, Nutritional Risk, and Application of Nutritional Support among Hospitalized Patients in Guangzhou Hospitals. Asia Pacific Journal of Clinical Nutrition, 22, 54-59.
[21] Waitzberg, D.L., Caiaffa, W.T. and Correia, M.I.T.D. (2001) Hospital Malnutrition: The Brazilian National Survey (IBRANUTRI): A Study of 4000 Patients. Nutrition, 17, 573-580.
http://dx.doi.org/10.1016/S0899-9007(01)00573-1
[22] Boltong, A.G., Loeliger, J.M. and Steer, B.L. (2013) Using a Public Hospital Funding Model to Strengthen a Case for Improved Nutritional Care in a Cancer Setting. Australian Health Review, 37, 286-290.
http://dx.doi.org/10.1071/AH13010
[23] Shaw, C., Fleuret, C., Pickard, J.M., Mohammed, K., Black, G. and Wedlake, L. (2014) Comparison of a Novel, Simple Nutrition Screening Tool for Adult Oncology Inpatients and the Malnutrition Screening Tool (MST) against the Patient-Generated Subjective Global Assessment (PG-SGA). Supportive Care in Cancer, 23, 47-54.
http://dx.doi.org/10.1007/s00520-014-2319-8
[24] Wu, B.W., Yin, T., Cao, W.X., Gu, Z.D., Wang, X.J., Yan, M. and Liu, B.Y. (2009) Clinical Application of Subjective Global Assessment in Chinese Patients with Gastrointestinal Cancer. World Journal of Gastroenterology, 15, 35423549.
http://dx.doi.org/10.3748/wjg.15.3542
[25] Righini, C.A., Timi, N., Junet, P., Bertolo, A., Reyt, E. and Atallah, I. (2013) Assessment of Nutritional Status at the Time of Diagnosis in Patients Treated for Head and Neck Cancer. European Annals of Otorhinolaryngology, Head and Neck Diseases, 130, 8-14.
http://dx.doi.org/10.1016/j.anorl.2012.10.001
[26] De Blaauw, I., Deutz, N.E.P. and Von Meyenfeldt, M.F. (1997) Metabolic Changes in Cancer Cachexia—Second of Two Parts. Clinical Nutrition, 16, 223-228.
http://dx.doi.org/10.1016/S0261-5614(97)80033-7
[27] van Cutsem, E. and Arends, J. (2005) The Causes and Consequences of Cancer-Associated Malnutrition. European Journal of Oncology Nursing, 9, 51-63.
http://dx.doi.org/10.1016/j.ejon.2005.09.007
[28] Abbott, J., Teleni, L., McKavanagh, D., Watson, J., McCarthy, A. and Isenring, E. (2014) A Novel, Automated Nutrition Screening System as a Predictor of Nutritional Risk in an Oncology Day Treatment Unit (ODTU). Supportive Care in Cancer, 22, 2107-2112.
http://dx.doi.org/10.1007/s00520-014-2210-7
[29] Amaral, T.F., Cabral, S., Alves, P. and Kent-Smith, L. (2008) An Evaluation of Three Nutritional Screening Tools in a Portuguese Oncology Centre. Journal of Human Nutrition and Dietetics, 21, 575-583.
http://dx.doi.org/10.1111/j.1365-277X.2008.00917.x
[30] Wakahara, T., Shiraki, M., Murase, K., Fukushima, H., Matsuura, K., Fukao, A., Kinoshita, S., Kaifuku, N., Arakawa, N., Tamura, T., Iwasa, J., Murakami, N., Deguchi, T. and Moriwaki, H. (2007) Nutritional Screening with Subjective Global Assessment Predicts Hospital Stay in Patients with Digestive Diseases. Nutrition, 23, 634-639.
http://dx.doi.org/10.1016/j.nut.2007.06.005
[31] Kondrup, J., Allison, S.P., Elia, M., Vellas, B. and Plauth, M. (2003) ESPEN Guidelines for Nutrition Screening 2002. Clinical Nutrition, 22, 415-421.
http://dx.doi.org/10.1016/S0261-5614(03)00098-0
[32] Kruizenga, H.M., Van Tulder, M.W., Seidell, J.C., Thijs, A., Ader, H.J. and van Bokhorst-de van der Schueren, M.A. (2005) Effectiveness and Cost-Effectiveness of Early Screening and Treatment of Malnourished Patients. American Journal of Clinical Nutrition, 82, 1082-1089.

  
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