Appetite in Palliative Cancer Patients and Its Association with Albumin, CRP and Quality of Life in Men and Women—Cross-Sectional Data from the Palliative D-Study

Abstract

Albumin is an important biochemical marker in palliative cancer care, used for assessment of nutritional status, disease severity and prognosis. Our primary aim was to investigate sex differences in the association between appetite and albumin levels in palliative cancer patients. We also aimed to study associations between appetite and C-reactive protein (CRP), Quality of Life (QoL), pain and fatigue. In the Palliative D-cohort, consisting of 266 men and 264 women, we found a correlation between appetite and albumin; low appetite, measured with the Edmonton Symptom Assessment System, correlated significantly with low albumin in men: (r = −0.33, p < 0.001), but not in women (r = −0.03, p = 0.65). In a regression analysis adjusted for confounding factors, results were similar. Lower appetite was correlated with higher CRP in men (r = 0.27, p < 0.001), but not in women (r = 0.12, p = 0.05). Appetite was correlated with QoL, fatigue and pain in both men and women; those with a low appetite had a low QoL and high fatigue- and pain-scores (p < 0.001). In conclusion, our results indicated possible sex differences in the associations between appetite and albumin, and between appetite and CRP, in palliative care patients. Understanding these associations could provide additional value for clinical practice.

Patients’ self-reported overall wellbeing correlates with concurrent reported symptoms: analysis of the Edmonton Symptom Assessment System

“…These observations are consistent with similar studies that have been reported in the literature. 9,44,62–64 Yennurajalingam et al 44 used the ESAS patient-reported outcome questionnaire to investigate factors associated with a feeling of wellbeing among 826 advanced lung or non-colonic gastrointestinal cancer patients and observed that patient-reported wellbeing was significantly associated with tiredness. Wilding et al 63 also investigated the associations between cancer-related symptoms, health-related quality of life and poor psychological outcomes in 13,097 prostate cancer patients treated with androgen deprivation therapy (ADT) and reported that clinically significant tiredness was strongly associated with poor wellbeing in patients.…”

“…These observations are consistent with other similar studies that have been reported in the literature. 9,23,44,45,62–64…”

“…These observations are consistent with other similar studies that have been reported in the literature. 9,23,44,45,[62][63][64] Receiver operating characteristics (ROC) analysis Results from the ROC analysis show the AUROC ranging from 0•644 for nausea to 0•833 for tiredness. The ESAS-PHY had a greater AUROC of 0•862 indicating that the ESAS-PHY may be better at predicting moderate-to-severe wellbeing than using the individual ESAS symptoms scores.…”

Association between Survival Duration of Older Patients with Advanced Unresectable Pancreatic Cancer and Appetite Loss: A Retrospective Cohort Study

“…[ 37 ]. Decision making regarding observation and assessment is vital for administrating effective advanced directives [ 23 , 38 ]. Therefore, assessment of appetite loss by patients and their families is useful for advanced directives and palliative care for unresectable pancreatic cancers.…”

“…Care level was divided into two groups (dependent: ≥1 and non-dependent: <1) based on the burden on caregivers and families. Appetite loss was assessed based on the Edmonton Symptom Assessment System, and this information was obtained from the review of systems by the nurses at the first visit for each patient [ 23 ].…”