Conséquences d'une comorbidité trop souvent négligée en cancérologie: la dénutrition

Kaikani, Wafaa; Bachmann, Patrick

doi:10.1684/bdc.2009.0875

Cited by 17 publications

(11 citation statements)

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“…As identified by other authors [ 6 , 23 ], malnourished patients are not only older, but are significantly more likely to suffer from dementia or depression. It has been proven on numerous occasions that patients with malnutrition present a raised morbidity and mortality risk [ 3 , 24 , 25 ]. Clinical parameters could serve as surrogate endpoints for the increased morbidity of malnourished patients.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem!

et al. 2015

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BackgroundMalnutrition is an under-recognized problem in hospitalized patients. Despite systematic screening, the prevalence of malnutrition in the hospital did not decrease in the last few decades. The aim of our study was to evaluate the prevalence of malnutrition and to determine the explicit daily calorie intake of hospitalized patients, to identify the risk factors of developing malnutrition during hospitalization and the effect on the financial reimbursement according to the German DRG-system.Material/Methods815 hospitalized patients were included in this study. The detection of malnutrition was based on the nutritional-risk-screening (NRS) and subjective-global-assessment (SGA) scores. A trained investigator recorded the daily calorie and fluid intake of each patient. Furthermore, clinical parameters, and the financial reimbursement were evaluated.ResultsThe prevalence of malnutrition was 53.6% according to the SGA and 44.6% according the NRS. During hospitalization, patients received on average 759.9±546.8 kcal/day. The prevalence of malnutrition was increased in patients with hepatic and gastrointestinal disease and with depression or dementia. The most important risk factors for malnutrition were bed rest and immobility (OR=5.88, 95% CI 2.25–15.4). In 84.5% of patient records, malnutrition was not correctly coded, leading to increased financial losses according to the DRG-system (94.908 Euros).ConclusionsHospitalized patients suffer from inadequate nutritional therapy and the risk for developing malnutrition rises during the hospital stay. The early screening of patients for malnutrition would not only improve management of nutritional therapy but also, with adequate coding, improve financial reimbursement according to the DRG-system.

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Section: Discussionmentioning

confidence: 99%

Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem!

et al. 2015

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“…[1] So cancer patients should be screened for malnutrition at frequent intervals and managed accordingly. [23] Actual physician practice, however, is often inadequate in addressing the nutrition aspects of cancer patients. [4] The various nutrition assessment methods may be arbitrarily divided into subjective (dietetic history), objective (serum albumin, hemoglobin, body mass index (BMI), weight lost in 1-6 months), or comprehensive nutrition assessment tools (scored Patient Generated Subjective Global Assessment (PG-SGA), Malnutrition Universal Screening Tool, and Mini Nutritional Assessment).…”

Section: Introductionmentioning

confidence: 99%

Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Das

Patel

Dave

et al. 2014

South Asian J Cancer

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Aim:To assess the nutritional status of gynecological cancer patients using scored Patient Generated Subjective Global Assessment (PG-SGA) then compare it with the body mass index (BMI), hemoglobin, serum albumin, and approximate percentage weight lost in last 1 month so as to find any one parameter that can be used in place of the comprehensive assessment tool.Materials and Methods:Sixty gynecological cancer patients were assessed for their nutritional status using BMI, serum albumin, hemoglobin, percentage weight lost in last 1 month, and scored PG-SGA. Correlation, sensitivity, specificity, and predictive values of the former four parameters compared to scored PG-SGA were calculated.Results:88.33% of cases were at risk of or had some degree of malnutrition according to scored PG-SGA. Serum albumin level ≤ 2 g/dl had highest specificity and positive predictive value at 1, whereas percentage weight lost in last month had better overall sensitivity, specificity, and positive and negative predictive values of 0.5833, 0.9444, 0.875, and 0.7727, respectively. The Pearson's correlation coefficient between scored PG-SGA and percentage weight lost in last 1 month was 0.784, highest among all the parameters.Conclusion:88.33% of gynecologic cancer cases had some degree of malnutrition or were at risk of malnutrition. Approximate percentage weight lost in last 1 month, that is, ≥ 5% may be used in place of the comprehensive scored PG-SGA to triage the patients in case the latter is not used for some reason. Severe hypoalbuminemia ≤ 2 g/dl is an indicator of severe malnutrition in gynecologic cancer cases.

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“…Cancer cachexia is a common event during treatment of cancer patients. It may reach prevalence of 60–80% in advanced cancers [1–4], with severe implications for quality of life, occupational possibilities and treatment outcomes, directly contributing to 30% of cancer deaths [3–6, 48].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, medical oncologists and other healthcare professionals treating patients with cancer seem to neglect patients’ nutritional issues [8–10, 48]. This should not surprise and underscores an astonishing European report for cancer pain management where half of the patients believed that their quality of life was not considered a priority in their overall care by their health care professionals [49].…”

Section: Discussionmentioning

confidence: 99%

Global coverage and consistency of guideline recommendations for cancer cachexia on the Web in 2011 and 2018

Mauri¹,

Zafeiri²,

Yerolatsite³

et al. 2019

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Introduction Cancer cachexia is a common associate of cancer and has a negative impact on both patients’ quality of life and overall survival. Nonetheless its management remains suboptimal in clinical practice. Provision of medical recommendations in websites is of extreme importance for medical decision making and translating evidence into clinical practice. Aim of the study To scrutinize the magnitude, consistency and changes over time of cancer-cachexia recommendations for physicians on the Web among oncology related societies. Intercontinental, continental, national and socioeconomic variations were further analyzed. Material and methods Web identification of oncology related societies and prospective analyses of relative Web guideline recommendations for physicians on cancer-cachexia at different time-points. Results In June 2011, we scrutinized 144,000 Web pages. We identified 275 societies, of which 270 were eligible for analyses: 67 were international (African, American, Asian, European, Oceania and Intercontinental), 109 belonged to the top 10 countries with the highest development index and 94 pertained to 10 countries with a long lasting tradition in medical oncology. Conclusions The magnitude of cancer cachexia recommendations for physicians on the Web at a global level was scant both for coverage and consistency, and at any time-point considered: 3.7% (10/270) in 2011 and 8.1% (22/270) in 2018. The proportion of societies giving evidence-based and updated recommendations for cancer cachexia for physicians was only 1.1% (3/270) in 2011 and 2.96% (8/270) in 2018. Continent, national highest developmental index, oncology tradition and economic-geographic areas were not found to influence Web guideline provision.

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Conséquences d'une comorbidité trop souvent négligée en cancérologie: la dénutrition

Cited by 17 publications

References 0 publications

Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem!

Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem!

Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters

Global coverage and consistency of guideline recommendations for cancer cachexia on the Web in 2011 and 2018

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