Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: Early intervention protocol

Nutrition. 2019 Jan:57:148-153. doi: 10.1016/j.nut.2018.05.021. Epub 2018 Jun 18.

Abstract

Objectives: Malnutrition is frequent in patients with cancer and is associated with a higher rate of morbidity and mortality. However, a significant number of patients at nutritional risk remain undetected due to the lack of a routine screening procedure during diagnosis. Costa del Sol Hospital in Marbella (Málaga), Spain has implemented a protocol for outpatients with cancer aimed at identifying and treating malnutrition at an early stage. The aim of this study was to determine the prevalence of nutritional risk and the rate of malnutrition when cancer is diagnosed.

Methods: We conducted a complete assessment of the nutritional status of patients with cancer of the upper digestive tract (esophagus, stomach, pancreas, or biliary tract) or head and neck cancer. Using the Nutriscore tool at the first oncology consultation, a screening for nutritional risk was performed for patients with other solid tumors. When nutritional risk was detected, a complete nutritional assessment was conducted.

Results: Of 295 consecutive patients, 21.4% were found to be at nutritional risk (Nutriscore ≥5). After complete assessment, a moderate degree of malnutrition was observed in 76% and severe malnutrition in 12%. Among patients with colorectal cancer or tumors of gynecologic origin, only 7.5% presented nutritional risk, but 52.8% presented cachexia.

Conclusion: The high rate of malnutrition observed and the identification of cachexia at an early stage highlight the importance of obtaining early identification of patients at risk to improve the efficacy of nutritional interventions.

Keywords: Cancer; Malnutrition; Nutriscore; Nutritional screening; Oncology outpatients; Protocol.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cachexia / epidemiology
  • Cachexia / etiology
  • Clinical Protocols
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / diagnosis
  • Digestive System Neoplasms / complications
  • Digestive System Neoplasms / diagnosis
  • Early Diagnosis
  • Female
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / diagnosis
  • Humans
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / epidemiology
  • Malnutrition / etiology
  • Malnutrition / therapy*
  • Mass Screening*
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Nutrition Assessment*
  • Nutritional Status*
  • Outpatients*
  • Prevalence
  • Referral and Consultation
  • Risk Assessment
  • Spain / epidemiology
  • Urogenital Neoplasms / complications
  • Urogenital Neoplasms / diagnosis