Nutritional Assessment of Cancer Patients in Tehran, Iran

Potassium titanyl phosphate laser resection of tongue T1/T2 squamous cell carcinoma - a cross-sectional study of quality of life and nutritional outcomes

INTRODUCTION

Increasing emphasis has been placed on measurement of quality of life (QOL) as a central criterion for assessment of success of any medical treatment. The aim of our study was to assess the nutritional and quality of life of patient-reported outcomes among patients who have undergone laser resection of tongue cancer.

MATERIALS AND METHODS

A cross-sectional study was undertaken of patients treated with KTP laser resection of T1/T2 tongue squamous cell carcinoma (SCC) between 2011-2019. University of Washington Quality of life 4 questionnaire (UW-QOL) and the abridged scored patient-generated subjective global assessment (AB PG-SGA) were used. Scores were correlated to analyse the QOL and nutritional status.

RESULTS

20 patients participated and were categorised into three groups based on AB PG-SGA score. The physical and social-emotional QOL scores were higher for patients who had a better nutritional status. There was a linear negative correlation between the AB PG-SGA score, physical and social-emotional domains of the QOL. No association was found between histopathological differentiation, neck dissection surgeries and the AB PG-SGA score.

CONCLUSIONS

The use of the KTP laser to excise tongue T1 and T2 SCC yields acceptable results in terms of QOL and patient-reported nutritional outcomes. There is a significant trend identifying that as a patient's nutritional status improves quality of life is enhanced and vice versa. The QOL and the nutritional status of patients were not affected by the different histopathological grades of SCC or whether they had undergone a neck dissection or not.

Assessment of Nutritional Status and Correlation of Factors With Body Mass Index of Cancer Patients: A Cross-Sectional Study

BACKGROUND

Decreased diet intake and malnourishment have profound implications on cancer patients' quality of life and survival. Malnutrition increases the risk of postoperative complications, increases hospital length stays, reduces patient's tolerance to radiation and chemotherapy treatment, and results in poor response to treatment. In the present study, we intended to assess the nutritional status of cancer patients and find the correlation of body mass index with anthropometric and blood parameters.

MATERIAL & METHODS

The study was prospective and cross-sectional, and 104 patients with newly diagnosed solid tumors were included. Patient demographics, symptoms, and anthropometric and blood parameters were collected. The correlation was estimated with Pearson's correlation coefficient. A p-value of less than 0.05 was considered significant.

RESULTS

The association between stages of the disease, dental status, type of diet, and BMI was p=0.701, 0.216, and 0.422, respectively, and was not statistically significant. The anthropometric parameters mid upper arm circumference (MUAC cm), mid arm circumference (MAC cm), and triceps skinfold thickness (TSF mm) correlated with body mass index (BMI kg/m2) and had statistically significant p values of 0.0001, 0.0001, and 0.033, respectively. The correlation was assessed between hemoglobin, red cell distribution width, neutrophil-to-lymphocyte ratio, and serum albumin levels with BMI, but except for albumin (p=0.05), no other blood parameter correlated.

CONCLUSION

Nutritional assessment is vital in recognizing patients at risk of treatment-associated complications and poor responders to treatment. In this study, BMI correlated with anthropometric parameters MUAC, MAMC, and TSF. Baseline dietary assessments of patients will help focus on the nutritional build-up of patients before starting treatment.

Nutritional Status and Its Determinants among Adult Cancer Patients Undergoing Chemotherapy Treatment at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia

Background

Malnutrition is a common problem in cancer patients. It has an impact on all aspects of the patient's life such as increasing the risk of infection, treatment toxicity, hospital stay, and health-care costs. Factors influencing the nutritional status of adult cancer patients undertaking chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, the purpose of this study is to assess the nutritional status and its determinants among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital.

Objectives

The objective of this study is to determine the nutritional status and its determinants among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital.

Methods

A cross-sectional study was conducted among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital Oncology Treatment Center, from January to May 2021. The data were gathered through a face-to-face interview and chart review method. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 25 for statistical analysis. Multivariable logistic regression analysis was used to determine the association between nutritional status and potential risk factors. A P value less than 0.05 was used to determine statistical significance.

Result

This study revealed that 48.1% of participants have some level of malnutrition. Lowest wealth index AOR 0.06 (0.016–0.2), food insecurity AOR 0.1 (0.05–0.24), vomiting AOR 0.2 (0.110–.444), poor appetite AOR 0.2 (0.11–0.44), no diarrhea AOR 2.6 (1.34–5.00), and poor functioning AOR 0.3 (0.2–0.54) were significantly associated with good nutritional status. Conclusion and Recommendation. The prevalence of malnutrition among adult cancer patients undergoing chemotherapy treatment at HUCSH was high. Wealth index, food security, poor appetite, diarrhea, and performance status were significantly correlated with the nutritional status of the patients. To improve the patient's nutritional status, economic support, early nutritional screening, and assessment, management of chemotherapy-induced symptoms should be considered.

The Prevalence of Thyroid Cancer in Iran: a Systematic Review and Meta-analysis

Cancer is the most common malignant tumor of the endocrine glands and comprises 1% of all malignant cancers and its incidence is still increasing. No comprehensive study summarizing the results of these studies was found. Therefore, this study aimed to determine the prevalence of thyroid cancer in Iran in a systematic review and meta-analysis. In this review, studies were extracted by searching the national and international databases of SID, MagIran, IranMedex, IranDoc, and Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) from 1997 to September 2019. Simple random effects model was used for data analysis and heterogeneity of studies was investigated with I ² index. Data were analyzed using Comprehensive Meta-Analysis (version 2) software. In 28 reviewed articles, the prevalence of thyroid cancer in Iran was reported to be 3.5% with a sample size of 100,869 (95% CI: 2.7-4.4%). Regarding heterogeneity on the basis of meta-regression, there was no significant difference between the effect of the year of study (P = 0.531) and sample size (P = 0.864) and the prevalence of thyroid cancer in Iran. The results of this study indicated that the prevalence of thyroid cancer is high in Iran. Therefore, appropriate strategies should be put in place by providing feedback to hospitals in order to improve the aforementioned situation, and troubleshoot and monitor at all levels.

A multi-centre survey on hospital malnutrition: result of PNSI study

Background

Disease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university f.

Methods

Persian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA).

Results

In total, 2109 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.68 ± 14.65 years and 25.44 ± 6.25 kg/m², respectively. Malnutrition (SGA-B & C) was identified in 23.92% of the patients, 26.23 and 21% of whom were among the admitted and discharged patients, respectively. The highest prevalence of malnutrition was in burns (77.70%) and heart surgery (57.84%) patients. Multivariate analysis presented male gender (OR = 1.02, P < 0.00), malignant disease (OR = 1.40, P < 0.00), length of hospital stay (OR = 1.20, P < 0.00), and polypharmacy (OR = 1.06, P < 0.00) as independent risk factors for malnutrition. Malnutrition was not associated with age (P = 0.10).

Conclusion

This study provides an overall and comprehensive illustration of hospital malnutrition in Iran university hospitals, finding that one out of four patients were malnourished; thus, appropriate consideration and measures should be taken to this issue.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00741-1.

Factors influencing the occurrence of electrolyte disorders in cancer patients

Objective:

The objective of this study was to determine the magnitude of electrolyte disorders and influencing factors among cancer patients in Southwest Ethiopia.

Methods:

Facility-based cross-sectional study was conducted in Jimma Medical Center (JMC). Eighty-four cancer patients admitted to JMC were recruited for this study. A structured questionnaire and serum electrolyte measurements were used for data collection. Bivariate and multiple logistic regression was employed to determine the association between electrolyte disorders and associated factors among admitted cancer patients. P value ⩽ 0.05 was used as a cut point to declare statistical significance.

Result:

The overall prevalence of electrolyte disorders was 60.7%. The presence or absence of comorbid diseases, age, body mass index (BMI), nutritional status, and current prescribed medication use were associated with electrolyte disorders. Younger patients had lower odds for electrolyte disorders (odds ratio (OR) = 0.128 (P value = 0.05) and OR = 0.08 (P value = 0.033)) for the first and the second quartile, respectively. Underweight patients had a threefold likelihood to develop electrolyte disorders (OR = 3.13 (P value = 0.043)) than having normal BMI. Compared with those in need of nutritional intervention, patients not in need of nutritional intervention had lower odds for the disorders (OR = 0.109 (P value = 0.006)). Medication had increased the likelihood of electrolyte disorders by 5.5 times than with no medication (P value = 0.023). Those who had comorbid disease had 10 times likely to develop electrolyte disorders than those who did not have comorbid diseases (P value = 0.004).

Conclusion:

Electrolyte disorders were prevalent in cancer patients. Age, BMI, nutritional condition, comorbid disease, and prescribed drugs were the predictors of electrolyte disorders in cancer patients. Authors recommend routine screening of electrolyte disorders in cancer patients and special emphasis on controlling and managing risk factors.

Patient-Generated Subjective Global Assessment (PG-SGA) predicts length of hospital stay in lung adenocarcinoma patients

The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma (LUAD). The Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 LUAD patients without epidermal growth factor receptor (EGFR) mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing LUAD. According to the PG-SGA, 63 (16·3 %), 174 (44·7 %) and 78 (20·1 %) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36·2 %) patients based on the NRS 2002. The average LOS for tumour patients in Northern China was 12·5 d. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P < 0·001), NRS 2002 (P < 0·001) and latest weight loss (P < 0·001) predicted the longer LOS. LOS was related to nutritional status and hospitalisation expenses (P < 0·001). LUAD patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P < 0·001). In Northern Chinese patients with LUAD, a risk for undernutrition evaluated by the PG-SGA, the NRS 2002 and recent weight loss, but not BMI, could predict a longer LOS.

Prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy treatment in cancer center, Ethiopia: cross-sectional study

INTRODUCTION

Malnutrition is a serious problem that causes high morbidity and mortality among cancer patients. There was no sufficient empirical evidence on the prevalence of malnutrition and associated factors among adult cancer hospitalized patients in Ethiopia.

OBJECTIVE

This study aimed to assess the prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy in cancer center, Ethiopia 2019.

METHODS

A cross-sectional study was conducted among a sample of 281 patients selected using systematic sampling among cancer patients receiving chemotherapy. Data were collected by patient interviews and chart reviews using a structured questioner adapted from a subjective global assessment tool. Data were analyzed by SPSS version 24.0. Descriptive statistics such as frequency distribution, mean, median, and standard deviation were used to describe characteristics. Bivariate and multivariable analyses using logistic regression models were used.

RESULT

Of the 281 participating patients, 58.2% had malnutrition, which was higher among females (51.6%) than males (48.4%). The mean body mass index was 20.24 ± 3.6. Of all, 41.9% had moderate weight loss, 21.1% had severe weight loss and 52.3% had weight loss in the past two weeks. Stage four cancer (AOR = 7.2, 95% CI: 1.3-38.5), loss of appetite (AOR = 4.5, 95% CI; 1.5-17.2) and diarrhea (AOR = 7.8, 95% CI: 2.95-20.5) were significantly associated with malnutrition.

CONCLUSION

The prevalence of malnutrition among cancer patients who receive chemotherapy was high. Stage of cancer, appetite loss, and presence of diarrhea was found to be significant factors for malnutrition.

Comprehensive assessment of nutritional status and nutritional-related complications in newly diagnosed esophageal cancer patients: A cross-sectional study

BACKGROUND & AIMS

Malnutrition is prevalent in upper gastrointestinal cancer patients. The purpose of this study was a comprehensive assessment of nutritional status in newly diagnosed patients with esophageal cancer.

METHODS

Newly diagnosed esophageal cancer patients were referred to a chemo-radiation referral center in Mashhad, Iran, between February 2017 to February 2019. Anthropometric indices, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, body composition, dietary intake, nutritional-related complications, and laboratory tests were assessed.

RESULTS

One hundred and eighty-nine patients with a mean age of 67.1 ± 12 and a male to female ratio of 98 to 91 were included. Ninety-seven (51.3%) of patients had experienced significant weight loss and 56 (29.6%) were underweight at diagnosis. According to PG-SGA, 179 (94.7%) needed nutritional interventions. Reduced muscle mass and low handgrip strength were observed in 70 (39.4%) and 26 (14.4%) of patients, respectively. Inadequate intakes of energy (less than 24 kcal/kg/day) and protein (less than 1.2 g/kg/day) were found in 146 (77.8%) and 171 (91%) patients, respectively. The mean total daily energy and protein intakes of subjects were 943.8 ± 540 kcal/day, and 30.6 ± 21 g/day, respectively. The most common nutritional-related complications were as follows: dysphagia (84.8%), anorexia (31.6%), constipation (62.1%), esophageal pain (48.4%), and dyspepsia (41.1%).

CONCLUSION

Our study demonstrated a high prevalence of malnutrition in newly diagnosed esophageal cancer patients. This fact demonstrates the importance of early screening of nutritional status via PG-SGA tool, clinical evaluation, dietary intake evaluations, and laboratory tests, based on which effective nutritional interventions and Symptoms management may be introduced in these patients.

Effects of medical nutrition therapy compared with general nutritional advice on nutritional status and nutrition-related complications in esophageal cancer patients receiving concurrent chemoradiation: A randomized controlled trial

OBJECTIVE: The purpose of this randomized controlled trial study was to assess the effects of medical nutrition therapy (MNT) compared with general nutritional advice (NA) on nutritional status in esophageal cancer (EC) patients during Chemoradiation (CRT). METHOD: The sample includes one hundred newly diagnosed patients with EC. The MNT group received individualized nutritional therapy. The NA group received general nutritional advice at the beginning of the participation. Patient-Generated- Subjective Global Assessment (PG-SGA), anthropometric indices, body composition, dietary intake, laboratory tests, and nutrition-related complications were assessed. RESULTS: Forty-nine cases were in the MNT group. The MNT group had significantly more favorable energy (26.4±14.1 vs. 18.2±11.2 kcal/kgw.day) and protein (1±0.6 vs. 0.7±0.4 g/kgw.day) intake than the NA group at the final evaluation. The PG-SGA score diminished but not significantly in both groups (11±6 vs. 12±6). As compared to the NA group, patients in the MNT group experienced more frequently no weight loss (21% vs. 11%) or mild weight loss (40% vs 35%) during the treatment. Meanwhile, moderate weight loss was more frequently observed in the NA group (26% vs. 44%). In the MNT group, those with severe weight loss had not proper adherence to the nutritional protocol. Mid-upper arm circumference, body composition, laboratory tests, physical performance, and nutrition-related complications were not significantly different between the two groups. CONCLUSION: As compared to general NA, MNT improved energy and macronutrients intake in patients with EC undergoing CRT which resulted in less severe weight loss and potentially better nutritional status.

Antropometria versus avaliação subjetiva nutricional no paciente oncológico

Resumo Objetivo Comparar os resultados da antropometria e avaliação subjetiva nutricional aplicadas ao paciente oncológico. Métodos Estudo transversal com pacientes em tratamento de quimioterapia entre março e junho de 2017. Os instrumentos aplicados foram a antropometria (Índice de Massa Corporal, percentual de gordura corporal, massa muscular e edema) e a Avaliação Subjetiva Global Produzida pelo Próprio Paciente. Os dados foram digitados no programa Microsoft Excel®. As análises estatísticas foram realizadas no programa SPSS® 21.0. Realizaram-se medidas de tendência central (média e desvio-padrão), frequência absoluta e percentual. As análises ocorreram por meio do Teste t e Correlação de Pearson, adotando-se um nível de significância de 5%. Resultados Dentre os 99 participantes, 60,6% apresentaram eutrofia, segundo o Índice de Massa Corporal, 24,2% com depleção de gordura, 51,5% com depleção muscular grave ou moderada e 87,9% com edema. A categorização da Avaliação Subjetiva Global Produzida pelo Próprio Paciente foi de 31,3% participantes bem nutridos, 37,4% desnutridos moderadamente e 31,3% desnutridos graves. Houve incompatibilidade do diagnóstico nutricional proveniente do Índice de Massa Corporal e Avaliação Subjetiva Global Produzida pelo Próprio Paciente, em decorrência da alta frequência de edema nos participantes. Conclusão Os resultados apontaram que o Índice de Massa Corporal não deve ser considerado um indicador único de avaliação do paciente oncológico, necessitando-se de avaliação antropométrica completa associada à Avaliação Subjetiva Global Produzida pelo Próprio Paciente.

Assessment of Body Composition in a Group of Pediatric Patients With Cancer: A Single Romanian Center Experience

Cancer patients are particularly susceptible to nutritional depletion. From March 2014 to December 2015, we assessed 146 patients consecutively hospitalized in a tertiary emergency pediatric hospital. The patients were divided into 2 groups: group I, patients with cancer (43 patients), and group II, the control group consisting of 103 age-matched and sex-matched healthy patients. The anthropometric parameters (weight-W, height-H, body mass index [BMI], middle upper arm circumference [MUAC], tricipital skinfold thickness [TST]) and biochemical parameters (proteins, albumin) were comparatively evaluated. Fat mass (FM, kg and %), fat-free mass (FFM, kg), muscle mass (MM, kg), and total body water (TBW, %) were measured in both groups using Tanita BC 420 S MA Analyzer. Anthropometric and biochemical parameters in group I were significantly different from those in group II for weight, height, BMI, MUAC, TST, protein, and albumin (P<0.05). In the study group, FM was much lower compared with controls 16.9% (3.4% to 33.3%) versus 20.3% (6.6% to 38.4%); (P=0.001), and TBW was much higher 60.8% (48.8% to 70.6%) versus 58.5% (45.2% to 68.6%) (P=0.004). FFM and MM were not statistically different in the 2 groups. The results highlight the complex changes of nutritional status in pediatric patients with cancer.

Assessing activity limitation among cancer survivors in Korea using data from a nationwide survey

BACKGROUND

More than 1 million cancer survivors reside in Korea. We here investigated activity limitations of cancer survivors compared to controls without a history of cancer.

MATERIALS AND METHODS

Using the 4th and 5th Korea National Health and Nutrition Examination Survey (2007-2012) data, we identified 1,155 adult cancer survivors. Activity limitations were defined as limitation in activities of daily living, experience of lying in a sickbed, and number of days lying in a sickbed during the last month. Descriptive analysis and multiple logistic regression compared these measures for survivors and controls by sex and age groups.

RESULTS

Approximately 29.4% of cancer survivors reported limitation in activities of daily living, 14.6% experienced lying in a sickbed, and 4.3% experienced more than 15 days lying in a sickbed during the last month. After controlling for demographic and health-related factors, cancer survivors were more likely to report activity limitation than controls. The associations were similar across sex and age groups.

CONCLUSIONS

Cancer survivors have increased activity limitation compared to controls and these limitations persist across sex and age. Targeted interventions and improved management are essential for improving cancer survivor daily life.

Nutritional risk assessment in critically ill cancer patients: systematic review

Objective

To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature.

Methods

The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words “nutritional risk assessment”, “critically ill” and “cancer”.

Results

Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values < 87 were significantly associated with mortality. A high Prognostic Inflammatory and Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found.

Conclusion

None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic Score and Patient-Generated Subjective Global Assessment, is suggested given that their use is simple, feasible and useful in such cases.

Clinical determinants of weight loss in patients with esophageal carcinoma during radiotherapy: a prospective longitudinal view

PURPOSE

The prevalence of weight loss in esophageal carcinoma patients is high and associated with impairment of physical function, increased psychological distress and low quality of life. It is not known which factors may contribute to weight loss in patients with esophageal carcinoma during radiotherapy in China. The objective of this study was to identify the associated demographic and clinical factors influencing weight loss.

METHODS

We evaluated 159 esophageal carcinoma patients between August 2010 and August 2013 in a cross- sectional, descriptive study. Patient characteristics, tumor and treatment details, psychological status, adverse effects, and dietary intake were evaluated at baseline and during radiotherapy. A multivariate logistic regression analyss was performed to identify the potential factors leading to weight loss.

RESULTS

64 (40.3%) patients had weight loss ≥ 5% during radiotherapy. According to logistic regression analysis, depression, esophagitis, and loss of appetite were adverse factors linked to weight loss. Dietary counseling, early stage disease and total energy intake ≥ 1,441.3 (kcal/d) were protective factors.

CONCLUSIONS

It was found that dietary counseling, TNM stage, total energy intake, depression, esophagitis, and loss of appetite were the most important factors for weight loss. The results underline the importance of maintaining energy intake and providing dietary advice in EC patients during RT. At the same time, by identifying associated factors, medical staff can provide appropriate medical care to reduce weight loss. Further studies should determine the effect of these factors on weight loss and propose a predictive model.

Nutrient intake and nutritional status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia

BACKGROUND

Cancer therapy in Malaysia primarily focuses on the clinical management of patients with cancer and malnutrition continues to be one of the major causes of death in these patients. There is a dearth of information on the nutrient intake and status of newly diagnosed patients with cancer prior to the initiation of treatment. The present study aims to assess the nutrient intake and status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia.

METHODS

A cross-sectional study was conducted using a convenient sample of newly diagnosed adult patients with cancer (n = 70) attending the Oncology clinic, Hospital Universiti Sains Malaysia in the East Coast of Peninsular Malaysia. Information on socio-demographic characteristics, clinical status, anthropometry, dietary intake and biochemical data including blood samples was obtained.

RESULTS

The mean (SD) age, triceps skin fold (TSF), mid upper arm circumference (MUAC) and body mass index (BMI) of participants was 21.1(3.9) years, 17.6(7.9) mm, 24.1(5.5) cm, and 21.1(3.9) Kg/m(2), respectively; 39% participants had BMI <18.5 Kg/m(2). One-third of newly diagnosed patients with cancer were undernourished (i.e. women: MUAC <220 mm; men: <230 mm). The proportion (%) of participants with low haemoglobin (<120 g/L) and serum albumin (<38 g/dL) were 62% and 26%, respectively. The older women had significantly lower macro and micro nutrient intakes compared to men in the same age group (P <0.05).

CONCLUSIONS

At the time of diagnosis, greater than one-third of patients with cancer from the East Coast of Peninsular Malaysia were underweight and undernourished. The majority of patients with cancer had poor micronutrient intakes; the older women had a poor macro and micronutrient intakes. Before the initiation of rigorous clinical management of patients with cancer, screening for nutritional status, subsequent nutrition counseling, and interventions are essential to improve their nutritional status; consequently, response to cancer therapy, survival and quality of life.

Association of nutritional status with quality of life in breast cancer survivors

Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey

BACKGROUND/OBJECTIVES

The aim of this study was to perform a retrospective analysis characterizing patients receiving tube feeding following percutaneous endoscopic gastrostomy (PEG) tube placement between 2004 and 2012 at Erciyes University Hospital in Turkey.

SUBJECTS/METHODS

Patients above the age of 18 years who required long-term enteral tube feeding were studied. All PEGs were performed using the pull-through technique by one experienced endoscopist. Demographic, clinical outcomes and PEG-related complication data were collected.

RESULTS

Of the 128 subjects studied, 91 were men (71%) and 37 were women (29%). The mean age of this patient population was 54 ± 19 years. The most common reason for PEG tube insertion was the inability to consume oral diet due to complications of cerebrovascular disease (27%), while cerebral hypoxia, occurring after nonneurological medical disorders, was the second most common indication (23%). A total of 70 patients (55%) had chronic comorbidities, with hypertension being the most common (20%). The most common procedure-related complication was insertion-site bleeding, which occurred in 4% of patients. Long-term complications during 1 year were insertion-site cellulitis, gastric contents leakage and peristomal ulceration, which occurred in 14%, 5% and 0.5% of patients, respectively. There were no PEG insertion-related mortalities; 1-year mortality was unrelated to the indication for PEG tube insertion.

CONCLUSIONS

PEG tube insertion was a safe method to provide enteral access for nutrition support in this hospitalized patient population.

Comparison of nutritional status assessment parameters in predicting length of hospital stay in cancer patients

BACKGROUND & AIMS

Undernutrition has been associated with an increased length of hospital stay which may reflect the patient prognosis. The aim of this study was to quantify and compare the association between nutritional status and handgrip strength at hospital admission with time to discharge in cancer patients.

METHODS

An observational prospective study was conducted in an oncology center. Patient-Generated Subjective Global Assessment, Nutritional Risk Screening 2002 and handgrip strength were conducted in a probabilistic sample of 130 cancer patients. The association between baseline nutritional status, handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome.

RESULTS

Nutritional risk ranged from 42.3 to 53.1% depending on the tool used. According to Patient-Generated Subjective Global Assessment severe undernutrition was present in 22.3% of the sample. The association between baseline data and time to discharge was stronger in patients with low handgrip strength (adjusted hazard ratio, low handgrip strength: 0.33; 95% confidence interval: 0.19-0.55), compared to undernourished patients evaluated by the other tools; Patient-Generated Subjective Global Assessment: (adjusted hazard ratio, severe undernutrition: 0.45; 95% confidence interval: 0.27-0.75) and Nutritional Risk Screening 2002: (adjusted hazard ratio, with nutritional risk: 0.55; 95% confidence interval: 0.37-0.80).

CONCLUSIONS

An approximate 3-fold decrease in probability of discharge alive was observed in patients with low handgrip strength. Decreasing handgrip strength tertiles allowed to discriminate between patients who will have longer hospital stay, as well as undernutrition and nutritional risk assessed by Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002.