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Rong Y, Liu Y, Tang SY, Ju XJ, Li H. Caregiver-involved nutritional support and mindfulness training for patients with gastrointestinal cancer: Effects on malnutrition risk and mood. World J Gastrointest Oncol 2025; 17:103515. [DOI: 10.4251/wjgo.v17.i4.103515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 12/16/2024] [Accepted: 01/20/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND The participation of caregivers, who play a crucial role in the recovery of patients with gastrointestinal tumors, in family nutrition support decisions can help tailor nutrition plans to meet the specific needs and lifestyle habits of the patient, thereby enhancing the effectiveness of nutritional intake.
AIM To assess the impact of caregiver-shared decision-making in family nutritional support with mindfulness-based behavioral therapy on the risk of malnutrition and mood states in patients with gastrointestinal tumors.
METHODS Patients with gastrointestinal tumors (n = 118) treated at the Jiangnan University Affiliated Hospital between December 2021 and March 2024 were assigned to the observation (n = 59) and control (n = 59) groups using the random number table method. In addition to the standard treatment and basic nursing measures implemented in the control group, the integrated approach was implemented in the observation group. The nutritional and mood state indicators, compliance, and satisfaction before and 6 months after implementing the intervention were compared between the groups.
RESULTS The body mass index, serum albumin levels, and transferrin levels, as well as the scores for all seven dimensions of the Profile of Mood States questionnaire, in the observation were higher than those in the control group after the 6-month follow-up period (P < 0.05). However, the Nutrition Risk Screening 2002 and Mindful Attention Awareness Scale scores were lower than those in the control group (P < 0.05). The compliance and satisfaction rates were 94.92% and 98.31%, respectively, which were higher than those of the control group (79.66% and 88.14%, respectively; P < 0.05).
CONCLUSION The implementation of the integrated approach significantly reduced the risk of malnutrition and improved mood states in patients with gastrointestinal tumors. Moreover, the compliance and satisfaction rates were higher.
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Affiliation(s)
- Yan Rong
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Yan Liu
- Department of Medical Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Shu-Yin Tang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Xian-Jing Ju
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Hui Li
- Division of Infection Management, The First Affiliated Hospital of Soochow University, Suzhou 225000, Jiangsu Province, China
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Seid A, Debebe Z, Ayelign A, Abeje M, Endris BS, Assefa M, Jemal A. Malnutrition Diagnosed by Patient-Generated Subjective Global Assessment and the Risk of All-Cause Mortality in Adults With Gastrointestinal Cancer: A Systematic Review and Meta-Analysis. J Hum Nutr Diet 2025; 38:e70012. [PMID: 39817621 DOI: 10.1111/jhn.70012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 12/23/2024] [Accepted: 12/30/2024] [Indexed: 01/18/2025]
Abstract
INTRODUCTION Several reviews have highlighted that the Patient-Generated Subjective Global Assessment (PG-SGA) is the best diagnostic tool for assessing nutritional status in cancer patients. However, previous meta-analyses summarizing the prevalence of malnutrition and overall survival in patients with gastrointestinal (GI) cancer are quite limited. This study aims to determine the overall prevalence and association between malnutrition, as defined by the PG-SGA, and mortality in adults with GI cancer. METHODS A comprehensive systematic review of articles published from 2005 to 2023 was conducted using Google Scholar, PubMed, Web of Sciences and Scopus. The PRISMA guideline was followed to organize the entire content. A random-effects meta-analysis model using R Studio was performed to quantify the pooled proportion and hazard ratios (HRs). Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using I2 and Baujat plots. This study was registered in PROSPERO under the protocol number CRD42023465685. RESULTS In this study, 46 publications with 23,235 participants were included in the final meta-analysis. The overall prevalence of malnutrition among adults with GI cancer, as determined by the PG-SGA, was 61% (95% CI: 51%-70%, I2 = 99%). The pooled prevalence of moderate and severe malnutrition were 38% (95% CI: 31%-45%, I2 = 96%) and 21% (95% CI: 13%-31%, I2 = 98%), respectively. By cancer type, malnutrition was more common in patients with oesophageal cancer (78%, 95% CI: 45%-94%, I2 = 99%) and gastric cancer (75%, 95% CI: 68%-81%, I2 = 87%). Additionally, the overall risk (pooled HR) of malnutrition on mortality among GI cancer patients was 2.02 (95% CI: 1.63%-2.5%, I2 = 23%). CONCLUSION Malnutrition is common in adults with GI cancer and doubles the risk of all-cause mortality. These results emphasize the importance of ongoing efforts in prevention, early assessment, and intervention for malnutrition to minimize mortality rates.
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Affiliation(s)
- Awole Seid
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zelalem Debebe
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Ayelign
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melsew Abeje
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bilal Shikur Endris
- Department of Nutrition and Dietetics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmedin Jemal
- Department of Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, USA
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Wang J, Liu B, Chen J. Validity of the Global Leadership Initiative on Malnutrition criteria in East Asian patients with gastric cancer: a comprehensive narrative review. Front Nutr 2024; 11:1462487. [PMID: 39634550 PMCID: PMC11614637 DOI: 10.3389/fnut.2024.1462487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 11/04/2024] [Indexed: 12/07/2024] Open
Abstract
Background Malnutrition is a significant public health issue for patients with gastric cancer, particularly in East Asia, the region most affected globally. In response to the absence of adequate tools for assessing nutritional status, the Global Leadership Initiative on Malnutrition (GLIM) criteria were established in 2018, aiming to standardize the diagnosis of malnutrition. However, there is no consensus on the value of GLIM criteria for evaluating the nutritional status of patients with gastric cancer in East Asia. Given these facts, our study aimed to assess the validity of the GLIM criteria in East Asian patients with gastric cancer. Methods We conducted a rapid critical review of available literature, summarizing the existing problems in GLIM applications and possible improvement directions. After systematically summarizing the literature published in PubMed, Web of Science, and Cochrane Library, a total of 13 articles involving 7,679 cases were included in this study. Results The results indicated a lack of sufficient data on sensitivity and specificity to fully validate the GLIM criteria for diagnosing malnutrition in East Asian patients with gastric cancer. Additionally, some studies have reported moderate agreement between the GLIM and the PG-SGA. Furthermore, malnutrition defined by GLIM is a risk factor for short and long-term outcomes in East Asian patients with gastric cancer. However, the prognostic effect of moderate malnutrition on these patients remains controversial. Conclusion Despite being in the early application stages, GLIM has shown promising potential in diagnosing and predicting the prognosis of malnutrition. However, future research should incorporate more comprehensive validity parameters, including sensitivity, specificity, and PPV/NPV, to achieve a more thorough understanding of GLIM's diagnostic efficacy. Furthermore, further optimization of GLIM is necessary to address the needs of more diverse populations and situations.
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Affiliation(s)
- Jian Wang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Bingyue Liu
- Hangzhou Zhanshi Traditional Chinese Hospital of Orthopaedics, Hangzhou, Zhejiang, China
| | - Jianxin Chen
- Department of Medical Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, China
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Sun Y, Huang L, Shen X, Yang Z, Xu B, Bao C, Shi Y. Development and validation of a dynamic nomogram for individualized prediction of survival in patients with colon cancer. Sci Rep 2024; 14:28033. [PMID: 39543274 PMCID: PMC11564546 DOI: 10.1038/s41598-024-78783-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 11/04/2024] [Indexed: 11/17/2024] Open
Abstract
Current tools for predicting survival outcomes in colon cancer patients predominantly rely on clinical and pathologic characteristics. However, accumulating evidence demonstrates a significant correlation between nutritional status and patient outcomes. This study aimed to establish a new dynamic nomogram for individualized prediction of postoperative overall survival (OS). The clinicopathological and nutritional data of colon cancer patients undergoing radical resection were retrospectively collected and randomly divided into the primary and validation cohorts. Risk factors on OS rates were investigated by Cox analyses and, the nomogram was constructed using significant predictors. Among 1,024 patients, 341 deaths were observed after median follow-up of 54 months. Five independent prognostic factors, including nutritional status assessments, were incorporated into the nomogram. The C-index regarding 1-, 3-, and 5-year OS were 0.830, 0.859, and 0.757 in the primary cohort and 0.843, 0.870, and 0.773 in the validation cohort, respectively. Calibration curves for the probability of OS exhibited an optimal agreement. Decision curve analyses revealed the greater application value of the nomogram than the TNM staging system. Based on the nomogram, patients could be stratified into three scenarios with significant prognostic classification (P < 0.0001). In conclusion, we developed and validated an easy-to-use dynamic nomogram for predicting postoperative OS in colon cancer patients.
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Affiliation(s)
- Yuting Sun
- Department of Infectious Diseases, Jiangnan University MedicalCenter, 68 Zhongshan Road, Wuxi, 214000, Jiangsu, China
| | - Longchang Huang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Xiaoming Shen
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Zenghui Yang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Binghua Xu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China
| | - Chuanqing Bao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China.
| | - Yifan Shi
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214000, Jiangsu, China.
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Fu L, Song L, Zhou X, Chen L, Zheng L, Hu D, Zhu S, Hu Y, Gong D, Chen CL, Ye X, Yu S. Serum metabolomics analysis of malnutrition in patients with gastric cancer: a cross sectional study. BMC Cancer 2024; 24:1195. [PMID: 39333934 PMCID: PMC11438121 DOI: 10.1186/s12885-024-12964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Although malnutrition is common in cancer patients, its molecular mechanisms has not been fully clarified. This study aims to identify significantly differential metabolites, match the corresponding metabolic pathways, and develop a predictive model of malnutrition in patients with gastric cancer. METHODS In this cross-sectional study, we applied non-targeted metabolomics using liquid chromatography-mass spectrometry to explore the serum fingerprinting of malnutrition in patients with gastric cancer. Malnutrition-specific differential metabolites were identified by orthogonal partial least-squares discriminant analysis and t-test and matched with the Human Metabolome Database and the LIPID Metabolites and Pathways Strategy. We matched the corresponding metabolic pathways of malnutrition using pathway analysis at the MetaboAnalyst 5.0. We used random forest analyses to establish the predictive model. RESULTS We recruited 220 malnourished and 198 non-malnourished patients with gastric cancer. The intensities of 25 annotated significantly differential metabolites were lower in patients with malnutrition than those without, while two others were higher in patients with malnutrition than those without, including newly identified significantly differential metabolites such as indoleacrylic acid and lysophosphatidylcholine(18:3/0:0). We matched eight metabolic pathways associated with malnutrition, including aminoacyl-tRNA biosynthesis, tryptophan metabolism, and glycerophospholipid metabolism. We established a predictive model with an area under the curve of 0.702 (95% CI: 0.651-0.768) based on four annotated significantly differential metabolites, namely indoleacrylic acid, lysophosphatidylcholine(18:3/0:0), L-tryptophan, and lysophosphatidylcholine(20:3/0:0). CONCLUSIONS We identified 27 specific differential metabolites of malnutrition in malnourished compared to non-malnourished patients with gastric cancer. We also matched eight corresponding metabolic pathways and developed a predictive model. These findings provide supportive data to better understand molecular mechanisms of malnutrition in patients with gastric cancer and new strategies for the prediction, diagnosis, prevention, and treatment for those malnourished.
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Affiliation(s)
- Liang Fu
- Department of Nursing, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
- Central Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Lixin Song
- School of Nursing, The University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, 78229, USA
| | - Xi Zhou
- Institute of Analysis, Guangdong Academy of Sciences (China National Analytical Center), Guangzhou, Guangzhou, 510070, China
| | - Lin Chen
- Central Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Lushan Zheng
- Department of Nursing, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Dandan Hu
- Department of Nursing, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Sha Zhu
- Department of Nursing, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Yanting Hu
- Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Daojun Gong
- Department of Gastrointestinal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Chun-Liang Chen
- School of Nursing, The University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, 78229, USA
| | - Xianghong Ye
- Department of Nursing, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China.
| | - Shian Yu
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China.
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Furness K, Huggins CE, Hanna L, Croagh D, Sarkies M, Haines TP. Effect of Communication Mode on Disclosure of Nutrition Impact Symptoms During Nutrition Intervention Delivered to People With Upper Gastrointestinal Cancer. Eval Health Prof 2024:1632787241267051. [PMID: 39045879 DOI: 10.1177/01632787241267051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Individuals diagnosed with upper gastrointestinal cancers experience a myriad of nutrition impact symptoms (NIS) compromise a person's ability to adequately meet their nutritional requirements leading to malnutrition, reduced quality of life and poorer survival. Electronic health (eHealth) is a potential strategy for improving the delivery of nutrition interventions by improving early and sustained access to dietitians to address both NIS and malnutrition. This study aimed to explore whether the mode of delivery affected participant disclosure of NIS during a nutrition intervention. Participants in the intervention groups received a nutrition intervention for 18 weeks from a dietitian via telephone or mobile application (app) using behaviour change techniques to assist in goal achievement. Poisson regression determined the proportion of individuals who reported NIS compared between groups. Univariate and multiple regression analyses of demographic variables explored the relationship between demographics and reporting of NIS. The incidence of reporting of NIS was more than 1.8 times higher in the telephone group (n = 38) compared to the mobile group (n = 36). Telephone predicted a higher likelihood of disclosure of self-reported symptoms of fatigue, nausea, and anorexia throughout the intervention period. A trusting therapeutic relationship built on human connection is fundamental and may not be achieved with current models of mobile health technologies.
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Affiliation(s)
- Kate Furness
- Department of Nutrition and Dietetics, Monash Health, Monash Medical Centre, Clayton, VIC, Australia
- Dietetics, Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, VIC, Australia
- Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Lauren Hanna
- Department of Nutrition and Dietetics, Monash Health, Monash Medical Centre, Clayton, VIC, Australia
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Daniel Croagh
- Upper Gastrointestinal and Hepatobiliary Surgery, Monash Medical Centre, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Mitchell Sarkies
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Terry P Haines
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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López-Plaza B, Álvarez-Mercado AI, Arcos-Castellanos L, Plaza-Diaz J, Ruiz-Ojeda FJ, Brandimonte-Hernández M, Feliú-Batlle J, Hummel T, Gil Á, Palma-Milla S. Efficacy and Safety of Habitual Consumption of a Food Supplement Containing Miraculin in Malnourished Cancer Patients: The CLINMIR Pilot Study. Nutrients 2024; 16:1905. [PMID: 38931260 PMCID: PMC11207068 DOI: 10.3390/nu16121905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Taste disorders (TDs) are common among systemically treated cancer patients and negatively impact their nutritional status and quality of life. The novel food approved by the European Commission (EFSA), dried miracle berries (DMB), contains the natural taste-modifying protein miraculin. DMB, also available as a supplement, has emerged as a possible alternative treatment for TDs. The present study aimed to evaluate the efficacy and safety of habitual DMB consumption in malnourished cancer patients undergoing active treatment. An exploratory clinical trial was carried out in which 31 cancer patients were randomized into three arms [standard dose of DMB (150 mg DMB/tablet), high dose of DMB (300 mg DMB/tablet) or placebo (300 mg freeze-dried strawberry)] for three months. Patients consumed a DMB tablet or placebo daily before each main meal (breakfast, lunch, and dinner). Throughout the five main visits, electrochemical taste perception, nutritional status, dietary intake, quality of life and the fatty acid profile of erythrocytes were evaluated. Patients consuming a standard dose of DMB exhibited improved taste acuity over time (% change right/left side: -52.8 ± 38.5/-58.7 ± 69.2%) and salty taste perception (2.29 ± 1.25 vs. high dose: 2.17 ± 1.84 vs. placebo: 1.57 ± 1.51 points, p < 0.05). They also had higher energy intake (p = 0.075) and covered better energy expenditure (107 ± 19%). The quality of life evaluated by symptom scales improved in patients receiving the standard dose of DMB (constipation, p = 0.048). The levels of arachidonic (13.1 ± 1.8; 14.0 ± 2.8, 12.0 ± 2.0%; p = 0.004) and docosahexaenoic (4.4 ± 1.7; 4.1 ± 1.0; 3.9 ± 1.6%; p = 0.014) acids in erythrocytes increased over time after DMB intake. The standard dose of DMB increased fat-free mass vs. placebo (47.4 ± 9.3 vs. 44.1 ± 4.7 kg, p = 0.007). Importantly, habitual patients with DMB did not experience any adverse events, and metabolic parameters remained stable and within normal ranges. In conclusion, habitual consumption of a standard 150 mg dose of DMB improves electrochemical food perception, nutritional status (energy intake, fat quantity and quality, fat-free mass), and quality of life in malnourished cancer patients receiving antineoplastic treatment. Additionally, DMB consumption appears to be safe, with no changes in major biochemical parameters associated with health status. Clinical trial registered (NCT05486260).
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Affiliation(s)
- Bricia López-Plaza
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
- Medicine Department, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Ana Isabel Álvarez-Mercado
- Department of Pharmacology, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
| | - Lucía Arcos-Castellanos
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
| | - Julio Plaza-Diaz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Francisco Javier Ruiz-Ojeda
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marco Brandimonte-Hernández
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
| | - Jaime Feliú-Batlle
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain;
- CIBERONC (CIBER Cancer), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany;
| | - Ángel Gil
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Samara Palma-Milla
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain
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An Z, Nie J, Huang Y, Fang P, Meng X, Cai C, Yu L. Contribution of non-socioeconomic factors to healthy quality of life in socioeconomically deprived patients with advanced gastrointestinal cancer: Measuring attributable fraction. J Adv Nurs 2024; 80:1154-1165. [PMID: 37710401 DOI: 10.1111/jan.15862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation. AIM This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors. DESIGN A retrospective study based on cross-sectional design. METHODS Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients. RESULTS The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors-gait, self-care ability, abdominal distension, nutritional status, weight loss and posture-has an independent positive impact on the development of a healthy quality of life for patients. CONCLUSIONS Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non-socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life. IMPLICATIONS FOR PRACTICE This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally. REPORTING METHOD This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Zifen An
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Jiaqi Nie
- School of Public Health, Wuhan University, Wuhan, China
| | - Yanfang Huang
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Pei Fang
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
- Medical Center for Gastrointestinal Surgery, Weifang People's Hospital, Weifang, Shandong, China
| | - Xianmei Meng
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Chunfeng Cai
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
| | - Liping Yu
- Wuhan University School of Nursing, Center for Nurturing Care Research, Wuhan University, Wuhan, China
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Azevedo MD, de Pinho NB, de Carvalho Padilha P, de Oliveira LC, Peres WAF. Clinical usefulness of the patient-generated subjective global assessment short form © for nutritional screening in patients with head and neck cancer: a multicentric study. Ecancermedicalscience 2024; 18:1662. [PMID: 38439803 PMCID: PMC10911671 DOI: 10.3332/ecancer.2024.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Indexed: 03/06/2024] Open
Abstract
Nutritional screening and assessment are considered essential steps in nutritional care for cancer patients, malnutrition remains underreported in clinical practice. The aim of this study was to analyse the clinical usefulness of the Patient-Generated Subjective Global Assessment short form (PG-SGA SF©) for nutritional screening in patients with head and neck cancer (HNC). This is a multicentre, cross-sectional study involving patients with HNC. The final score of the PG-SGA SF© was obtained and the nutritional status was diagnosed using the Patient-Generated Subjective Global Assessment (PG-SGA)®, classifying them as well-nourished or malnourished. Receiver operating characteristic curve, ordinal logistic regression, and C-statistic were used. In total, 353 patients with HNC were enrolled and the prevalence of malnutrition, according to the PG-SGA®, was 64.02% and the median final score of PG-SGA SF© was 11 points. The final score of the PG-SGA SF© had high accuracy (area under the curve = 0.915), and scores ≥9 had the best performance in diagnosing malnutrition. PG-SGA SF© final score ≥9 was associated with malnutrition (odds ratio = 28.32, 95% confidence interval= 15.98-50.17), with excellent discriminatory power (C-statistic = 0.872). In conclusion, the PG-SGA SF© demonstrated excellent performance for nutritional screening in patients with HNC. Given that it is a simple instrument that is faster to administer than the PG-SGA®, we recommend its use in clinical practice among such patients.
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Affiliation(s)
- Mariana Duarte Azevedo
- Department of Nutrition and Dietetics, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Patrícia de Carvalho Padilha
- Department of Nutrition and Dietetics, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Livia Costa de Oliveira
- Palliative Care Unit, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, RJ, Brazil
| | - Wilza Arantes Ferreira Peres
- Department of Nutrition and Dietetics, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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10
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Wang PP, Soh KL, Binti Khazaai H, Ning CY, Huang XL, Yu JX, Liao JL. Nutritional Assessment Tools for Patients with Cancer: A Narrative Review. Curr Med Sci 2024; 44:71-80. [PMID: 38289530 DOI: 10.1007/s11596-023-2808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/08/2023] [Indexed: 02/24/2024]
Abstract
Cancer patients are at high risk of malnutrition, which can lead to adverse health outcomes such as prolonged hospitalization, increased complications, and increased mortality. Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients. However, while many tools exist to assess malnutrition, there is no universally accepted standard. Although different tools have their own strengths and limitations, there is a lack of narrative reviews on nutritional assessment tools for cancer patients. To address this knowledge gap, we conducted a non-systematic literature search using PubMed, Embase, Web of Science, and the Cochrane Library from their inception until May 2023. A total of 90 studies met our selection criteria and were included in our narrative review. We evaluated the applications, strengths, and limitations of 4 commonly used nutritional assessment tools for cancer patients: the Subjective Global Assessment (SGA), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA), and Global Leadership Initiative on Malnutrition (GLIM). Our findings revealed that malnutrition was associated with adverse health outcomes. Each of these 4 tools has its applications, strengths, and limitations. Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients. It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.
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Affiliation(s)
- Peng-Peng Wang
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
- Nursing College of Guangxi Medical University, Nanning, 530021, China.
| | - Kim Lam Soh
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
| | - Huzwah Binti Khazaai
- Department of Biomedical Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Chuan-Yi Ning
- Nursing College of Guangxi Medical University, Nanning, 530021, China
| | - Xue-Ling Huang
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Jia-Xiang Yu
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
| | - Jin-Lian Liao
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
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Kasvis P, Vigano A, Bui T, Carli F, Kilgour RD. Cancer symptom burden negatively affects health-related quality of life in patients undergoing prehabilitation prior to liver resection: results from a 12-week randomized controlled trial. Appl Physiol Nutr Metab 2024; 49:64-76. [PMID: 37690126 DOI: 10.1139/apnm-2023-0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
TAKE HOME MESSAGE Cancer symptoms negatively affect health-related quality of life (HRQoL) in patients with cancer awaiting liver resection. Prehabilitation maintained HRQoL after surgery. Future studies should test whether relieving cancer symptoms can improve HRQoL.
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Affiliation(s)
- Popi Kasvis
- McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal, QC, Canada
- Supportive and Palliative Care Division, McGill University Health Centre, Montreal, QC, Canada
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Antonio Vigano
- McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal, QC, Canada
- Supportive and Palliative Care Division, McGill University Health Centre, Montreal, QC, Canada
| | - Tram Bui
- McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal, QC, Canada
| | - Franco Carli
- Department of Anesthesiology, McGill University Health Centre, Montreal, QC, Canada
| | - Robert D Kilgour
- McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal, QC, Canada
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
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12
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Al-Shahethi AH, Mahdi FA, Al-Shameri EA, Abol Gaith FM. Factors Associated With Malnutrition in Hospitalized Cancer Patients in a National Oncology Center in Conflict-Affected Settings in Sana'a, Yemen: An Institution-Based Cross-Sectional Study. Cureus 2023; 15:e45411. [PMID: 37859884 PMCID: PMC10584276 DOI: 10.7759/cureus.45411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2023] [Indexed: 10/21/2023] Open
Abstract
Background Cancer can significantly impact the nutritional status of patients, which can worsen related complications and reduce the effectiveness of treatment. Malnutrition is a common complication among cancer patients, especially among older adults. This study aims to determine the prevalence of malnutrition among hospitalized cancer patients and identify factors associated with malnutrition. Methodology and methods The cross-sectional descriptive study was performed on 296 cancer patients admitted to the National Oncology Referral Center in Sana'a, Yemen, between February 1 and March 31, 2022. Malnutrition was diagnosed through clinical assessment and screening tools such as screening tools, body mass index (BMI), weight loss percentage, and mid-upper arm circumference (MUAC). Descriptive statistics, chi-square, and multivariable logistic regression analysis were used to assess factors associated with malnutrition. Results Of the 296 patients included in the analysis, most were female 225 (76.0%), and the mean age was 45.8 years. The prevalence of undernutrition, as determined by the BMI score, was 48 (16.2%). The prevalence of malnutrition was higher in females 37 (16.4%) compared to males 11(15.5%). The data indicated that 49% of hospitalized patients had experienced weight loss of 5% or more. Multivariable logistic regression analysis showed that single (AOR=12.93, 95% CI: 1.17-142.77) or widowed (AOR=11.51, 95% CI: 1.05-126.03) marital status, weight loss (AOR=7.56, 95% CI: 3.00-18.69), stomach cancer (AOR=6.77, 95% CI: 1.66-27.70), and breast cancer (AOR=2.60, 95% CI: 1.12-6.03) were associated with an increased risk of malnutrition. Conclusions The study highlights the importance of evaluating and addressing the nutritional status of cancer patients, especially at the beginning and during treatment, to improve their clinical outcomes. Prospective studies are recommended to further investigate this issue.
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Affiliation(s)
- Ahmed H Al-Shahethi
- Department of Community Health and Nutrition, Faculty of Health Sciences, University of Al-Razi, Sana'a, YEM
- Department of Community Medicine, Faculty of Medicine, 21 September University of Medical and Applied Sciences, Sana'a, YEM
| | - Fares A Mahdi
- Department of Community Medicine, Faculty of Medicine, 21 September University of Medical and Applied Sciences, Sana'a, YEM
- Department of Nursing, Ibn Alnafis University, Sana'a, YEM
| | - Emad A Al-Shameri
- Department of Community Health and Nutrition, Faculty of Health Sciences, University of Al-Razi, Sana'a, YEM
| | - Fawz M Abol Gaith
- Department of Community Health and Nutrition, Faculty of Health Sciences, University of Al-Razi, Sana'a, YEM
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Amano T, Akiyoshi T, Furuta M, Saino Y, Mukai T, Hiyoshi Y, Nagasaki T, Yamaguchi T, Kawachi H, Fukunaga Y. Geriatric nutritional risk index after neoadjuvant chemoradiotherapy and survival in older patients with advanced rectal cancer. Int J Colorectal Dis 2023; 38:119. [PMID: 37157019 DOI: 10.1007/s00384-023-04425-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To investigate the clinical impact of malnutrition on the survival of older patients with advanced rectal cancer who underwent neoadjuvant chemoradiotherapy. METHODS We investigated the clinical significance of the geriatric nutritional risk index (GNRI) in 237 patients aged over 60 years with clinical stage II/III rectal adenocarcinoma who were treated with neoadjuvant long-course chemoradiotherapy or total neoadjuvant therapy followed by radical resection from 2004 to 2017. Pre-treatment and post-treatment GNRI were evaluated, with patients split into low (< 98) and high (≥ 98) GNRI groups. The prognostic impact of pre-treatment and post-treatment GNRI levels on overall survival (OS), post-recurrence survival (PRS), and disease-free survival (DFS) was evaluated using univariate and multivariate analyses. RESULTS Fifty-seven patients (24.1%) before neoadjuvant treatment and 94 patients (39.7%) after neoadjuvant treatment were categorized with low GNRI. Pre-treatment GNRI levels were not associated with OS (p = 0.80) or DFS (p = 0.70). Patients in the post-treatment low GNRI group had significantly poorer OS than those in the post-treatment high GNRI group (p = 0.0005). The multivariate analysis showed that post-treatment low GNRI levels were independently associated with poorer OS (hazard ratio, 3.06; 95% confidence interval, 1.55-6.05; p = 0.001). Although post-treatment GNRI levels were not associated with DFS (p = 0.24), among the 50 patients with recurrence, post-treatment low GNRI levels were associated with poorer PRS (p = 0.02). CONCLUSION Post-treatment GNRI is a promising nutritional score associated with OS and PRS in patients over 60 years with advanced rectal cancer treated with neoadjuvant chemoradiotherapy.
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Affiliation(s)
- Takahiro Amano
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takashi Akiyoshi
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Momoko Furuta
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoko Saino
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toshiki Mukai
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yukiharu Hiyoshi
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Toshiya Nagasaki
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomohiro Yamaguchi
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroshi Kawachi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yosuke Fukunaga
- Department of Colorectal Surgery, Gastroenterology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Xiang S, Yang YX, Pan WJ, Li Y, Zhang JH, Gao Y, Liu S. Prognostic value of systemic immune inflammation index and geriatric nutrition risk index in early-onset colorectal cancer. Front Nutr 2023; 10:1134300. [PMID: 37143476 PMCID: PMC10151795 DOI: 10.3389/fnut.2023.1134300] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
Background Systemic nutritional and inflammatory markers, which are easy to measure are associated with the progression and prognosis of many cancers. Nevertheless, among the various available indicators, optimal prognostic indicators for patients with early-onset colorectal cancer have not been identified. Therefore, the aim of this study was to identify optimal nutritional and inflammatory markers for early-onset colorectal cancer and examine the relationship between systemic nutritional and inflammatory markers before treatment and survival in patients with early-onset colorectal cancer. Methods We retrospectively collected data from 236 eligible patients with early-onset colorectal cancer. Area under the prognostic curve (AUC) and concordance index (C-index) were used to compare seven systemic nutritional and inflammatory markers to identify the optimal inflammatory immune markers. Univariate and multivariate COX regression analyses were used to evaluate the prognostic value of indicators in the total study population and different subgroups. Results The AUC and C-index showed that the systemic immune inflammation index (SII) and geriatric nutrition risk index (GNRI) had higher prognostic values than other systemic nutritional and inflammatory indicators. Compared with patients in the low SII group, those in the high SII group had lower overall survival (HR, 4.42, 95% CI, 2.36-8.27, p = 0.000). Compared with patients in the high GNRI group, those in the low GNRI group had lower overall survival (HR, 0.33, 95% CI, 0.19-0.56, p = 0.000). SII was negatively associated with GNRI (R = -0.3, p < 0.001), and both were correlated with the tumor stage. Conclusion SII and GNRI are suitable nutritional and inflammatory factors for predicting OS in patients with early-onset colorectal cancer; high SII and low GNRI were correlated with worse prognoses. Identifying the high inflammatory state and low nutritional state of patients before surgery and conducting active and timely therapeutic interventions could improve patient prognosis.
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Affiliation(s)
- Shuai Xiang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu-Xiao Yang
- Department of Gastroenterology, China-Japan Friendship Hospital of Peking University, Beijing, China
| | - Wen-Jun Pan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Li
- Department of Blood Transfusion, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun-Hao Zhang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Gao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yuan Gao,
| | - Shanglong Liu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
- Shanglong Liu,
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15
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Schuetz P, Sulo S, Walzer S, Krenberger S, Brunton C. Nutritional support during the hospital stay is cost-effective for preventing adverse outcomes in patients with cancer. Front Oncol 2022; 12:916073. [PMID: 36016618 PMCID: PMC9396738 DOI: 10.3389/fonc.2022.916073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Among patients with cancer, malnutrition remains common and is a key challenge in oncology practice today. A prior study from our group revealed that malnourished cancer inpatients who got nutritional treatment (intervention group) had lower mortality and improved functional and quality of life outcomes compared to inpatients without nutritional support (control group). Our present analysis aimed to determine whether the improved patient recovery by nutritional support was paralleled by cost-effectiveness of this nutritional care. Methods We analyzed hospital costs and health outcomes in patients with cancer, using a Markov simulation model with daily cycles to analyze the economic impact of nutritional support in malnourished inpatients with malignancies. We compared results for a nutritional intervention group and a control group across a 30-day timeframe. Five health states were designated (malnourished but stable, complications, intensive care unit (ICU) admission, discharge, death). Costs for the different health states were based on publicly available data for the Swiss medical system. Total patient cost categories included in-hospital nutrition, days spent in the normal ward, days in the ICU, and medical complications. Results Total per-patient costs for in-hospital supportive nutrition was Swiss francs (CHF) 129. Across a 30-day post-admission interval, our model determined average overall costs of care of CHF 46,420 per-patient in the intervention group versus CHF 43,711 in the control group-a difference of CHF 2,709 per patient. Modeled results showed a cost of CHF 1,788 to prevent one major complication, CHF 4,464 to prevent one day in the ICU, and CHF 3,345 to prevent one death. Recovery benefits of nutritional care were thus paralleled by cost-effectiveness of this care. Conclusion In-hospital nutritional support for oncology patients at nutritional risk is a low-cost intervention that has both clinical and financial benefits.
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Affiliation(s)
- Philipp Schuetz
- Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Suela Sulo
- Abbott Nutrition, Global Health Economics & Outcomes Research, Chicago, IL, United States
| | - Stefan Walzer
- MArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Germany
- State University Baden-Wuerttemberg, Loerrach, Germany
- Social Work & Health Care, University of Applied Sciences Ravensburg-Weingarten, Weingarten, Germany
| | | | - Cory Brunton
- Abbott Nutrition, Global Health Economics & Outcomes Research, Chicago, IL, United States
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Nutritional Treatment of Patients with Colorectal Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116881. [PMID: 35682464 PMCID: PMC9180662 DOI: 10.3390/ijerph19116881] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 12/12/2022]
Abstract
Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient’s nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients’ individual needs.
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17
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Zhang Z, Wan Z, Zhu Y, Wan H. Predictive validity of the GLIM criteria in treatment outcomes in cancer patients with radiotherapy. Clin Nutr 2022; 41:855-861. [DOI: 10.1016/j.clnu.2022.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/17/2022] [Accepted: 02/12/2022] [Indexed: 11/12/2022]
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Sulo S, Brunton C, Drawert S, Watson G, Hegazi R, Bastasch M. Increased Emergency Department Utilization and Costs for Medicare Cancer Patients with Malnutrition Diagnoses. J Nutr Health Aging 2022; 26:786-791. [PMID: 35934823 DOI: 10.1007/s12603-022-1826-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Malnutrition or its risk affects up to 70% of cancer patients. Compared to adequately nourished oncology patients, those with malnutrition experience more complications and have poorer prognoses, thus higher needs for healthcare. We compared utilization of emergency department (ED) services and costs for Medicare-covered cancer patients with or without a malnutrition diagnosis. METHODS We used the Centers for Medicare and Medicaid Services (CMS) Standard Analytic File to identify fee-for-service beneficiaries who had a cancer diagnosis, and had one or more outpatient claims in 2018. We totaled individual claims and costs for ED visits per beneficiary, then calculated mean per-person claims and costs for malnourished vs non-malnourished patients. RESULTS Using data from over 2.8 million claims of patients with cancer diagnoses, the prevalence of diagnosed malnutrition was 2.5%. The most common cancer types were genitourinary, hematologic/blood, and breast. Cancer patients with a malnutrition diagnosis, compared to those without, had a significantly higher annual total number of outpatient claims (21.4 vs. 11.5, P<.0001), including a 2.5-fold higher rate of ED visits (1.43 vs. 0.56, p<.0001). As result, such patients incurred more than 2-fold higher mean ED claim costs than did their adequately nourished counterparts ($10,724 vs. $4,935, P<.0001). CONCLUSIONS Our results suggest that malnutrition in cancer patients imposes a high outpatient burden on resource utilization and costs of care in terms of ED use. We propose that nutritional interventions can be used to improve health outcomes for people with cancer and to improve economic outcomes for patients and providers.
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Affiliation(s)
- S Sulo
- Suela Sulo, PhD, MSc, Abbott Nutrition, 100 Abbott Park Rd, Abbott Park, IL 60064, Office: 224-668-1377, Fax: 224-668-8355, E-mail:
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A Comparison of the Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment-Short Form (MNA-SF) Tool for Older Patients Undergoing General Surgery. J Clin Med 2021; 10:jcm10245860. [PMID: 34945154 PMCID: PMC8704256 DOI: 10.3390/jcm10245860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
The optimal malnutrition screening tool in geriatric surgery has yet to be determined. Herein, we compare two main tools in older patients undergoing general surgery operations. Older patients (>65 years old) who underwent general surgery operations between 2012 and 2017 in a tertiary centre were included. The Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment Short Form (MNA-SF) were used for nutritional risk assessment. Preoperative variables as well as postoperative outcomes were recorded prospectively. Agreement between tools was determined with the weighted kappa (κ) statistic. Multiple regression analysis was used to assess the association of the screening tools with postoperative outcomes. A total of 302 patients (median age 74 years, range: 65–92) were included. A similar number of patients were classified as medium/high risk for malnutrition with the MNA-SF and MUST (26% vs. 36%, p = 0.126). Agreement between the two tools was moderate (weighted κ: 0.474; 95%CI: 0.381–0.568). In the multivariate analysis, MNA-SF was associated significantly with postoperative mortality (p = 0.038) and with postoperative length of stay (p = 0.001). MUST was associated with postoperative length of stay (p = 0.048). The MNA-SF seems to be more consistently associated with postoperative outcomes in elderly patients undergoing general surgery compared with the MUST tool.
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Xi SJ, Cai WQ, Wang QQ, Peng XC. Role of circular RNAs in gastrointestinal tumors and drug resistance. World J Clin Cases 2021; 9:10400-10417. [PMID: 35004973 PMCID: PMC8686142 DOI: 10.12998/wjcc.v9.i34.10400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/26/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023] Open
Abstract
The incidence of gastrointestinal cancers has increased significantly over the past decade and gastrointestinal malignancies now rank among the leading causes of mortality globally. Although newer therapeutic strategies such as targeted therapies have greatly improved patient outcomes, their clinical success is limited by drug resistance, treatment failure and recurrence of metastatic disease. Therefore, there is an urgent need for further research identifying accurate and reliable biomarkers for precise treatment strategies. Circular RNAs (circRNAs) exhibit a covalently closed structure, high stability and biological conservation, and their expression is associated with the occurrence and development of gastrointestinal tumors. Moreover, circRNAs may significantly influence drug resistance of gastrointestinal cancers. In this article, we review the role of circRNAs in the occurrence and development of gastrointestinal cancer, their association with drug resistance, and potential application for early diagnosis, treatment and prognosis in gastrointestinal malignancies. Furthermore, we summarize characteristics of circRNA, including mechanism of formation and biological effects via mRNA sponging, chromatin replication, gene regulation, translational modification, signal transduction, and damage repair. Finally, we discuss whether circRNA-related noninvasive testing may be clinically provided in the future. This review provides new insights for the future development of diagnostics and therapeutics based on circRNAs in gastrointestinal tumors.
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Affiliation(s)
- Shi-Jun Xi
- Department of Pathophysiology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou 434023, Hubei Province, China
| | - Wen-Qi Cai
- Department of Pathophysiology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou 434023, Hubei Province, China
| | - Qin-Qi Wang
- Department of Pathophysiology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou 434023, Hubei Province, China
| | - Xiao-Chun Peng
- Department of Pathophysiology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou 434023, Hubei Province, China
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The Clinical Utility of the Geriatric Nutritional Risk Index in Predicting Postoperative Complications and Long-Term Survival in Elderly Patients with Colorectal Cancer after Curative Surgery. Cancers (Basel) 2021; 13:cancers13225852. [PMID: 34831005 PMCID: PMC8616423 DOI: 10.3390/cancers13225852] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/08/2021] [Accepted: 11/19/2021] [Indexed: 01/05/2023] Open
Abstract
Simple Summary Elderly cancer patients usually suffer with malnutrition. Preoperative malnutrition has been considered a poorer prognostic factor in cancer treatment. The geriatric nutritional risk index (GNRI) is a simple tool for predicting the risk of morbidity and mortality in elderly patients by using albumin, height, and body weight parameters. In this study, we evaluated whether GNRI is a reliable marker for postoperative complications and long-term survival. By retrospectively evaluating 1206 CRC patients aged over 75 years who underwent curative-intent surgery at Chang Gung Memorial Hospital, there were significantly more postoperative complications in the low GNRI group (p < 0.001) and GNRI was an independent risk factor for postoperative complications (HR: 1.774, p = 0.037). Overall survival and disease-free survival were significantly worse in the low GNRI group (both p < 0.001) and a GNRI < 98 was statistically identified as an independent prognostic factor for survival. Conclusively, GNRI can be a reliable biomarker in clinical practice. Abstract Research on the relationship between the geriatric nutritional risk index (GNRI) and postoperative complications/oncological outcomes in elderly colorectal cancer (CRC) patients is limited. This study investigated the prognostic value of the GNRI in aged CRC patients. We retrospectively analyzed 1206 consecutive CRC patients aged over 75 years who underwent curative-intent surgery from January 2008 to December 2015 and categorized them into high GNRI (≥98) and low GNRI (<98) groups according to a receiver operating characteristic (ROC) curve analysis. Uni- and multivariate logistic regression analysis were used to explore the association of the GNRI with postoperative complications. Kaplan–Meier survival analyses and the Cox proportional hazard model were used to explore the association between GNRI and survival. We discovered that GNRI is an independent risk factor for postoperative complications (HR: 1.774, p = 0.037). Surgical site infection, wound dehiscence and pneumonia were more common in patients with GNRI < 98. Survival analysis showed significantly worse overall survival and disease-free survival in the low GNRI group (both p < 0.001). In the multivariate analysis, GNRI < 98 was an independent risk factor for OS (HR: 1.329, p = 0.031) and DFS (HR: 1.312, p = 0.034). Thus, preoperative GNRI can be effectively used to predict postoperative complications and long-term survival in elderly CRC patients after curative surgery.
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22
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Sahin Kaya A, Bora S, Yetisyigit T. Evaluation of the Effect of Nutritional Status in Patients with Cancer Receiving Chemotherapy on Anthropometric Measurements and Quality of Life. Nutr Cancer 2021; 74:1994-2002. [PMID: 34590508 DOI: 10.1080/01635581.2021.1984541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study is to determine the nutritional status, anthropometric measurements and quality of life of adult patients with cancer receiving chemotherapy, and to evaluate their interactions. In this retrospective cross sectional study, information about the patients' demographic characteristics, anthropometric measurements, nutritional status, hand grip strengths which were measured with a portable digital hand dynamometer, and the quality of life scores were obtained from the patient files. According to NRS-2002, 16.3% of the patients were at the risk of malnutrition. The body weight, body mass index, waist circumference, hip circumference, mid-upper arm circumference, hand grip strength values of the individuals who had three or higher scores from NRS-2002 were significantly lower (p < 0.05). Considering the evaluation of the quality of life scores based on their nutritional status, the functional and general health score was significantly lower in patients at the risk of malnutrition and their symptom score was significantly higher (p < 0.05). The presence of nutritional risk in cancer patients is related to the quality of life. In conclusion, the nutritional status of patients with cancer should be evaluated regularly, and early intervention regarding this is important to increase the quality of life.
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Affiliation(s)
- Aysel Sahin Kaya
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Antalya Bilim University, Antalya, Turkey
| | - Sumeyye Bora
- Faculty of Health Sciences, Department of Nutrition and Diet, Haliç University, Istanbul, Turkey
| | - Tarkan Yetisyigit
- Department of Medical Oncology, King Hamad University Hospital, Muharraq Governorate, Bahrain
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Cardenas D, Correia MITD, Ochoa JB, Hardy G, Rodriguez-Ventimilla D, Bermúdez CE, Papapietro K, Hankard R, Briend A, Ungpinitpong W, Zakka KM, Pounds T, Cuerda C, Barazzoni R. Clinical Nutrition and Human Rights. An International Position Paper. Nutr Clin Pract 2021; 36:534-544. [PMID: 34013590 DOI: 10.1002/ncp.10667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political, and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
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Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | | | - Juan B Ochoa
- Department of Surgery, Ochsner Medical Center-New Orleans, New Orleans, Louisiana, USA
| | - Gil Hardy
- Ipanema Research Trust, Auckland, New Zealand
| | | | - Charles E Bermúdez
- Surgery and Nutrition Department, Clínica La Colina and Clínica del Country, Bogota, Colombia
| | - Karin Papapietro
- Nutrition Unit, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - Régis Hankard
- Nutrition Mobile Unit, CHU Tours, Université de Tours, European Institute for History and Culture of Food, University of Tours, Tours, France
| | - André Briend
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark and Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Katerina Mary Zakka
- Department of Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, Georgia, USA
| | - Teresa Pounds
- Department of Pharmacy, Wellstar Atlanta Medical Center, Atlanta, Georgia, USA
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rocco Barazzoni
- Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy
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24
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Cardenas D, Correia MITD, Ochoa JB, Hardy G, Rodriguez-Ventimilla D, Bermúdez CE, Papapietro K, Hankard R, Briend A, Ungpinitpong W, Zakka KM, Pounds T, Cuerda C, Barazzoni R. Clinical nutrition and human rights. An international position paper. Clin Nutr 2021; 40:4029-4036. [PMID: 34023070 DOI: 10.1016/j.clnu.2021.02.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 01/02/2023]
Abstract
The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
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Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, El Bosque University, Bogotá, Colombia.
| | | | - Juan B Ochoa
- Department of Surgery, Ochsner Medical Center-New Orleans, New Orleans, LA, USA.
| | - Gil Hardy
- Ipanema Research Trust, Auckland, New Zealand.
| | | | - Charles E Bermúdez
- Surgery and Nutrition Department, Clínica La Colina and Clínica Del Country, Bogota, Colombia.
| | - Karin Papapietro
- Nutrition Unit, Hospital Clínico de La Universidad de Chile, Santiago, Chile.
| | - Régis Hankard
- Nutrition Mobile Unit, CHU Tours, Université de Tours, European Institute for History and Culture of Food, University of Tours, France.
| | - André Briend
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark and Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | | | - Katerina Mary Zakka
- Department of Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, GA, USA.
| | - Teresa Pounds
- Department of Pharmacy, Wellstar Atlanta Medical Center, Atlanta, GA, USA.
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Rocco Barazzoni
- Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy.
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Gillis C, Richer L, Fenton TR, Gramlich L, Keller H, Culos-Reed SN, Sajobi TT, Awasthi R, Carli F. Colorectal cancer patients with malnutrition suffer poor physical and mental health before surgery. Surgery 2021; 170:841-847. [PMID: 33966805 DOI: 10.1016/j.surg.2021.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/31/2021] [Accepted: 04/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND To determine whether there is an association between preoperative nutritional status and preoperative physical function, patient-reported quality of life, and body composition in colorectal cancer patients awaiting elective surgery. METHODS We conducted a pooled analysis of individual baseline patient data (n = 266) collected from 5 prehabilitation trials in colorectal cancer surgery. All data were collected approximately 4 weeks before surgery. Each patient's nutritional status was evaluated using the Patient-Generated Subjective Global Assessment: scores 4-8 indicated need for nutritional treatment, whereas ≥9 indicated critical need for a nutrition intervention. Physical function was measured with the 6-minute walk test; patient-reported quality of life was captured with the SF-36; body mass and composition were determined using multifrequency bioelectrical impedance. RESULTS Mean Patient-Generated Subjective Global Assessment score was 5.3 (standard deviation: 3.9). Approximately two-thirds of patients had a Patient-Generated Subjective Global Assessment of 4-8 or ≥9 (n = 162/266). The 6-minute walk test was progressively worse with higher Patient-Generated Subjective Global Assessment scores (PG-SGA <4: 471(119) m; PG-SGA 4-8: 417(125) m; PG-SGA ≥9: 311(125) m, P < .001). Every component of the SF-36 was lower in those with a Patient-Generated Subjective Global Assessment ≥9 compared to Patient-Generated Subjective Global Assessment <4, indicating that malnourished patients suffer worse quality of life. Interestingly, only the male patients with a Patient-Generated Subjective Global Assessment ≥9 presented with statistically significant lower body mass, reduced fat-free mass index, and a lower percent body fat relative to those with Patient-Generated Subjective Global Assessment <4, in part due to the higher variability among the females. CONCLUSION The consequences of malnutrition are far-reaching and are strongly associated with the physical and mental health of colorectal cancer patients awaiting elective resection.
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Affiliation(s)
- Chelsia Gillis
- Department of Anesthesia, McGill University, Montreal, Canada.
| | - Lauren Richer
- Department of Anesthesia, McGill University, Montreal, Canada
| | - Tanis R Fenton
- Department of Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Nutrition Services, Alberta Health Services, Calgary, Canada
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Heather Keller
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada; Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology and Department of Oncology, Cumming School of Medicine, University of Calgary; Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Alberta, Canada
| | - Tolulope T Sajobi
- Cumming School of Medicine, Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Rashami Awasthi
- Department of Anesthesia, McGill University, Montreal, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University, Montreal, Canada
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Zhou HJ, Deng LJ, Wang T, Chen JX, Jiang SZ, Yang L, Liu F, Weng MH, Hu JW, Tan JY. Clinical practice guidelines for the nutritional risk screening and assessment of cancer patients: a systematic quality appraisal using the AGREE II instrument. Support Care Cancer 2021; 29:2885-2893. [PMID: 33638747 DOI: 10.1007/s00520-021-06094-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/18/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the quality of published clinical practice guidelines (CPGs) regarding the nutritional risk screening and assessment of cancer patients and to identify high-quality CPGs for clinical healthcare professionals. METHODS Guidelines for the nutritional risk screening and assessment of cancer patients were comprehensively searched in eight electronic databases, including The Lancet, PubMed, Cochrane Library, Excerpta Medica dataBASE (EMBASE), Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), and Wan Fang Data, through August 2020. Six relevant guideline databases, including the National Comprehensive Cancer Network (NCCN), the National Guideline Clearinghouse (NGC), the Guideline International Network (GIN), the New Zealand Guidelines Group (NZGG), the China Guideline Clearinghouse (CGC), and Medlive, and relevant nutrition society websites, were also searched through August 2020. The methodological quality of the included CPGs was appraised independently by three assessors using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II) tool. RESULTS Seven CPGs were located, and the domain with the highest percentage was "clarity of presentation" (85.44%), while the domain with the lowest percentage was "applicability" (40.26%). From the AGREE II results, two guidelines were rated as "strongly recommended," three were assessed as "recommended with modifications," and two were deemed as "not recommended." CONCLUSION Considering that the two "strongly recommended" guidelines were developed within the American and European contexts, translation, validation, and cultural adaptation are recommended prior to implementing these guidelines in other countries or healthcare contexts to improve their effectiveness and sensitivity for local cancer patients. TRIAL REGISTRATION PROSPERO registration of the study protocol: CRD42020177390 (July 5, 2020).
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Affiliation(s)
- Hong-Juan Zhou
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Li-Jin Deng
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Tao Wang
- College of Nursing and Midwifery Brisbane Center, Charles Darwin University, Brisbane, QLD, 4000, Australia
| | - Jin-Xiu Chen
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Su-Zhen Jiang
- Rehabilitation Hospital affiliated with Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Liu Yang
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Fang Liu
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Mei-Hua Weng
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Jing-Wen Hu
- Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Jing-Yu Tan
- College of Nursing and Midwifery Brisbane Center, Charles Darwin University, Brisbane, QLD, 4000, Australia.
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Rodrigues CN, Ribeiro Henrique J, Ferreira ÁRSI, Correia MITD. Ultrasonography and Other Nutrition Assessment Methods to Monitor the Nutrition Status of Critically Ill Patients. JPEN J Parenter Enteral Nutr 2020; 45:982-990. [PMID: 32700339 DOI: 10.1002/jpen.1966] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND This study aims to evaluate the use of ultrasonography (US) as an instrument to assess the quadriceps muscles in patients admitted to intensive care units (ICUs), comparing the evolution of US-assessed mass muscle to other nutrition methods. METHODS We conducted a prospective observational study of adult patients aged ≥18 years admitted to an ICU of the Hospital das Clínicas in Brazil. Quadriceps muscle measurements were performed by US, and adductor pollicis muscle thickness and arm, calf, and thigh circumferences were measured at admission and every 2 days within the first week. Nutrition status was assessed at baseline by using the Subjective Global Assessment and the Global Leadership Initiative on Malnutrition criteria. Mechanical ventilation time, length of hospital and ICU stay, and mortality were recorded. RESULTS Sixty patients were included. Reductions in quadriceps thickness and rectus femoris cross-sectional area were observed at landmarks two-thirds reduction of both measurements from days 1 and 3 to days 5 and 7 (P = .017 and P = .000, respectively). The mid arm circumference (MAC) was reduced. Malnourished patients had lower initial muscle mass. However, muscle mass loss was similar between nourished and malnourished individuals (P > .005). Clinical outcomes were not impacted by muscle loss. CONCLUSIONS US muscle mass assessment was able to detect short-term changes in critically ill patients but must be used with caution. MAC was also identified as a useful follow-up tool.
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Affiliation(s)
- Camila Neves Rodrigues
- CAPES Scholarship, Nutrition and Health Program, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Jessimara Ribeiro Henrique
- CAPES Scholarship, Food Sciences Post Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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