Malnutrition and nutrition impact symptoms (NIS) in surgical patients with cancer

Viana, Eduarda Cristina Rodrigues de Morais; Oliveira, Isadora da Silva; Rechinelli, Ana Beatriz; Marques, Isabele Lessa; Souza, Vanusa Felício de; Spexoto, Maria Cláudia Bernardes; Pereira, Taísa Sabrina Silva; Guandalini, Valdete Regina

doi:10.1371/journal.pone.0241305

Cited by 27 publications

(23 citation statements)

References 18 publications

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“…In addition, due to the pathological consumption of thyroid cancer, dysphagia symptoms, surgery and inflammation, a large amount of proteins and fats are consumed in the body, and patients may suffer from malnutrition status ( 15 , 16 ). One study ( 17 ) showed that patients with nutritional risk have a significantly higher incidence of postoperative infectious complications and a significantly longer hospital stay, so clinical workers need to pay attention to nutritional screening of surgical patients and the prognostic impact of nutritional risk on surgery. The results showed that the postoperative albumin, total protein, prealbumin levels, GQOLI-74 scores and total scores of the test group were higher than those of the control group; the first postoperative meal, first time out of bed and hospital stay were shorter than those of the control group; the postoperative 24 h VAS score, postoperative DCL-90 scores and total postoperative complication rate were lower than those of the control group.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Rehabilitation Efficacy and Nutritional Status of Patients After Endoscopic Radical Thyroidectomy by Fast Track Surgery Based on Nutritional Support

Liu

et al. 2022

Front. Surg.

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ObjectiveTo investigate and analyze the effect of fast track surgery (FTS) based on nutritional support on the improvement of rehabilitation efficacy and nutritional status of patients after radical lumpectomy for thyroid cancer.MethodsEighty-six patients admitted to our hospital for radical lumpectomy for thyroid cancer between April 2018 and April 2021 were selected, of which 40 patients admitted between April 2018 and April 2019 were included in the control group with conventional perioperative care. Forty-six patients admitted between May 2019 and April 2021 were included in the trial group with FTS care based on nutritional support. The two groups of patients were compared in terms of postoperative feeding time, length of stay, time out of bed, VAS scores, albumin (ALB), total protein (TP) and prealbumin (PA) levels, negative emotions [Mental Health Test Questionnaire (DCL-90)], quality of life [General Quality of Life Inventory (GQOLI-74)] and complication rates.ResultsThe patients in the trial group had shorter feeding time, hospitalization time and time out of bed than the control group (P < 0.05). After the intervention, ALB, TP and PA levels were higher in the trial group than in the control group vs. preoperatively (P < 0.05); VAS scores in the trial group were lower than VAS scores in the control group during the same period (P < 0.05). The postoperative DCL-90 scores of the trial group were lower than those of the control group (P < 0.05); the GQOLI-74 scores and total scores of the trial group were higher than those of the control group at the 3-month postoperative follow-up (P < 0.05). The overall incidence of complications such as hoarseness, choking on water, hand and foot numbness, wound infection, and hypocalemia was lower in the trial group than in the control group (P < 0.05).ConclusionThe implementation of FTS care based on nutritional support for patients after endoscopic radical thyroidectomyr can effectively improve the postoperative recovery and reduce their pain level, as well as help improve their nutritional status, negative emotions and improve their quality of life, which is worth promoting.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Rehabilitation Efficacy and Nutritional Status of Patients After Endoscopic Radical Thyroidectomy by Fast Track Surgery Based on Nutritional Support

Liu

et al. 2022

Front. Surg.

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“…It was suggested that this may be attributed to the higher levels of sensitivity of PG‐SGA in detecting malnutrition in patients with cancer and the inclusion of a high proportion of patients with gastrointestinal malignancies 26 . Patients with gastrointestinal malignancies often have nausea, vomiting, constipation, diarrhoea, or a combination of symptoms that affect nutritional status 39 . This suggests that the PG‐SGA may have advantages over SGA, when measuring malnutrition specifically in cancer surgical patients.…”

Section: Discussionmentioning

confidence: 99%

“…26 Patients with gastrointestinal malignancies often have nausea, vomiting, constipation, diarrhoea, or a combination of symptoms that affect nutritional status. 39 This suggests that the PG-SGA may have advantages over SGA, when measuring malnutrition specifically in cancer surgical patients.…”

Section: Summary Of Evidencementioning

confidence: 99%

Malnutrition and nutritional screening in patients undergoing surgery in low and middle income countries: A systematic review

Jones

Knight

Sremanakova

et al. 2022

JCSM Clinical Reports

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BackgroundThere is a high incidence of preoperative undernutrition in hospitalised patients in low and middle‐income countries (LMICs), leading to increased postoperative complications, length of hospital stay and early mortality. Review aims are to establish the prevalence of undernutrition and assess the use of validated nutritional screening tools in surgical patients across LMICs.MethodsProtocol was PRISMA compliant and Prospero registered (CRD42019126765). Twelve international databases were searched from January 1990 to April 2021. Included studies were on nutritional screening in adults (≥16 years) undergoing surgery in LMICs. Two researchers screened studies and assessed quality. Prevalence of undernutrition was presented as a weighted percentage with confidence intervals (CI).ResultsOf the 4649 records identified, 16 studies (n = 4032) were eligible. Subjective global assessment (SGA) or patient generated (PG)‐SGA were the tools used most widely. SGA and PG‐SGA showed a high prevalence of undernutrition overall (0.61, 95% CI 0.50, 0.73), with a proportion identified with moderate undernutrition (0.44, 95% CI 0.31, 0.57) or severe undernutrition (0.32, 95% CI 0.19, 0.45).ConclusionsData show the prevalence of undernutrition in surgical patients as high as three in five patients within LMICs. Results indicate that the SGA is suitable for assessing this group of patients and that it may be the most appropriate tool to use due to its subjectivity and reliability. PG‐SGA although similar includes more symptom assessment, which is important for nutritionally depleted cancer patients. The limited data on validity and reliability of nutritional screening tools in LMICs indicates further research is required.

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“…Tumors that originate from or have metastasized to the head and neck or gastrointestinal tract can cause dysphagia, early satiety, and malabsorption of nutrients. Chemotherapy and radiation can cause decreased appetite due to altered taste and smell, food aversions, nausea, vomiting, and diarrhea ( 34 , 35 ). Decreased appetite may also occur as a direct result of inflammation and altered hunger/satiety signaling in the hypothalamus ( 1 ).…”

Section: Cancer Cachexia Pathophysiologymentioning

confidence: 99%

Cancer cachexia: Pathophysiology and association with cancer-related pain

Law

2022

Front. Pain Res.

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Cachexia is a syndrome of unintentional body weight loss and muscle wasting occurring in 30% of all cancer patients. Patients with cancers most commonly leading to brain metastases have a risk for cachexia development between 20 and 80%. Cachexia causes severe weakness and fatigue and negatively impacts quality and length of life. The negative energy balance in cachectic patients is most often caused by a combination of increased energy expenditure and decreased energy intake. Basal metabolic rate may be elevated due to tumor secreted factors and a systemic inflammatory response leading to inefficiency in energy production pathways and increased energy demand by the tumor and host tissues. A growing body of research explores physiological and molecular mechanisms of metabolic dysregulation in cachexia. However, decreased energy intake and physical functioning also remain important contributors to cachexia pathogenesis. Pain associated with metastatic malignancy is significantly associated with inflammation, thus making inflammation a common link between cancer pain and cachexia. Pain may also influence appetite and food intake and exacerbate fatigue and functional decline, potentially contributing to cachexia severity. Cancer pain and cachexia often occur simultaneously; however, causal relationships remain to be established. Appropriate assessment and treatment of pain in advanced cancer patients may positively impact nutrition status and physical functioning, slowing the progression of cachexia and improving quality and length of life for patients.

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Malnutrition and nutrition impact symptoms (NIS) in surgical patients with cancer

Cited by 27 publications

References 18 publications

Analysis of the Rehabilitation Efficacy and Nutritional Status of Patients After Endoscopic Radical Thyroidectomy by Fast Track Surgery Based on Nutritional Support

Analysis of the Rehabilitation Efficacy and Nutritional Status of Patients After Endoscopic Radical Thyroidectomy by Fast Track Surgery Based on Nutritional Support

Malnutrition and nutritional screening in patients undergoing surgery in low and middle income countries: A systematic review

Cancer cachexia: Pathophysiology and association with cancer-related pain

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