Nutrition support in hospitalized cancer patients with malnutrition in China

Abstract

Background and objectives: Malnutrition has adverse impacts on survival of cancer patients. The aim of the present study was to investigate the prevalence of malnutrition, and the nutrition support status in hospitalized patients with cancer in China.

Methods and study design: A multi-center, cross-sectional study was conducted in 29 tertiary public hospital wards in 14 Chinese cities. Malnutrition was defined as weight loss (WL) >5% over the past 6 months or body mass index (BMI) <20 kg/m2 with WL >2%. The nutrition risk index (NRI) and performance status (PS) were evaluated.

Results: 1138 hospitalized cancer patients (93.4% of the initial sample, 662 men, 60.6±14.5 years) were enrolled. Overall, 41.3% of patients were malnourished. The percentage of nutritional disorders as determined by the NRI was 51.4%. PS was 0 in 50.3%, 1 in 15.4%, 2 in 13.9%, and 3 or 4 in 20.4%. Compared with patients with PS of 0-1, patients with PS of 3-4 had a relative risk of malnutrition of 1.275 (95% CI 0.250-0.488, p<0.0001). Only 38.6% of patients received nutrition support, of whom 45.0% of the malnourished and 31.9% of the non-malnourished patients did; 63.2% of patients complained of poor appetite, while merely 14.0% of patients had received nutrition counseling.

Conclusions: The prevalence of malnutrition is high in hospitalized cancer patients, and inappropriate use of nutritional interventions highlights the urgent need to define standard operating procedures and quality control process.