Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study

Abstract

Introduction: dysphagia and malnutrition are conditions that frequently appear together in hospitalized patients.Objectives: the main purpose of this study was to analyze the prevalence of malnutrition in patients with dysphagia included in the PREDyCES ® study as well as to determine its clinical and economic consequences.Methods: this is a substudy of an observational, cross-sectional study conducted in 31 sites all over Spain.Results: 352 dysphagic patients were included. 45.7% of patients presented with malnutrition (NRS ® -2002 ≥ 3) at admission and 42.2% at discharge. In elderly patients (≥ 70 years old) prevalence of malnutrition was even higher: 54.6% at admission and 57.5% at discharge. Also, prevalence of malnutrition was higher in urgent admissions versus those scheduled (45.7% vs 33.3%; p < 0.05) and when admitted to small hospitals vs. large hospitals (62.8% vs 43.9%; p < 0.001). In-hospital length of stay was higher in malnourished patients compared to those well-nourished (11.5 ± 7.1 days vs. 8.8 ± 6.05 days; p < 0.001), and in malnourished patients a tendency towards increase related-costs was also observed, even though it was not statistically significant (8 004 ± 5 854 € vs. 6 967 ± 5 630 €; p = 0.11). Length of stay was also higher in elderly patients (≥ 70 y/o) vs adults (< 70 y/o). 25% of dysphagic patients and 34.6% of malnourished patients with dysphagia received nutritional support during hospitalization.

Direct Percutaneous Endoscopic Jejunostomy: Procedural and Nutrition Outcomes in a Large Patient Cohort

“…Malnutrition is common in cancer and affects more than one‐third of patients with active cancer . Enteral feeding is preferred to parenteral nutrition (PN), which has several risks including infection, hyperglycemia, and liver dysfunction .…”

Nutritional experiences in head and neck cancer patients

“…Specialised nutrition competencies and skills are needed to make early detections of patients in need of nutritional support and to assess and initiate relevant nutritional support. Hospital stays are longer and costs per hospitalisation are higher in malnourished cancer patients, thus actions that may delay or prevent hospital admissions during treatment are desired (Maasberg et al, ; Planas et al, ; Pressoir et al, ). Updated international clinical guidelines on nutritional support in cancer patients recommend that dietitians play a central role in the multidisciplinary team responsible for the supportive care of HNC patients (Arends, Bachmann, et al, ; Thompson et al, ).…”

Prevalencia De Desnutricion Al Ingreso en Un Hospital General Basico

“…El resultado en muchas ocasiones se traduce en la dificultad para hacer estudios comparativos interseries por la utilización de herramientas distintas, aunque apropiadas, para su determinación (19)(20)(21)(22). Si la prevalencia de pacientes con desnutrición o riesgo nutricional en los hospitales es muy elevada (23,24), es más preocupante que solo un escaso porcentaje de estos pacientes ingresados reciben un aporte de energía y nutrientes adecuado a sus requerimientos (1,25), y los que sí reciben soporte nutricional en casi la mitad de los casos no lo hace durante el tiempo necesario (26). Por tanto, detectar con precocidad, y con los métodos más adecuados (27), el riesgo clínico y nutricional de los pacientes cuando ingresan en el hospital se convierte en la premisa indispensable para instaurar, de la manera más precoz posible también, un tratamiento nutricional suficiente en cantidad, calidad y temporalidad (24,28).…”