Scored patient-generated Subjective Global Assessment: Length of hospital stay and mortality in cancer patients

Abstract

Objective To determine the association of a scored patient-generated Subjective Global Assessment with mortality and length of hospital stay in cancer patients. Methods Cross-sectional study carried out between July and September 2014 using secondary data collection using data from 366 medical records of patients admitted to a hospital recognized as a cancer center of excellence. The present study included patients with hospital stay over than or equal three days and minimum age of 20 years. The patient-generated Subjective Global Assessment scores were calculated and compared with the patients’ clinical and anthropometric characteristics and outcomes (death and long length of stay in hospital). Results Of the 366 patients evaluated, 36.0% were malnourished. The presence of malnutrition, according to the scored patient-generated Subjective Global Assessment, was statistically associated with the presence of metastasis (52.4%). On the other hand, malnutrition, according to the body mass index in adults (55.8%) and in older elderly patients (54.2%), was associated with death (55.0%). The adjusted logistic regression model showed that the following factors were associated with prolonged hospitalization: early nutritional screening, presence of severe malnutrition, radiotherapy and chemotherapy, and surgical procedures. As for mortality, the associated factors were: male reproductive system tumor, presence of metastasis, clinical treatment, prolonged hospitalization, and the presence of some degree of malnutrition. Conclusion The patient-generated Subjective Global Assessment score is an important risk marker of prolonged hospitalization and mortality rates. It is a useful tool capable of circumventing significant biases in the nutritional evaluation of cancer patients.

Comparison of the GLIM, ESPEN and ICD-10 Criteria to Diagnose Malnutrition and Predict 30-Day Outcomes: An Observational Study in an Oncology Population

“…Cancer-related malnutrition affects between 30% and 70% of people with cancer, with the prevalence varying by cancer type, treatment modality and method of assessing malnutrition [ 2 , 3 , 4 ]. The adverse outcomes associated with cancer-related malnutrition have been widely reported, including, but not limited to, a decrease in treatment tolerance and increased mortality, hospital admission/readmission and length of hospital stay, leading to greater healthcare costs [ 3 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Early identification, timely assessment and treatment of malnutrition are recommended to facilitate optimal care and minimise the adverse outcomes associated with cancer-related malnutrition [ 13 ].…”

Infusão Calórica e Proteica versus Prescrição Dietética na Terapia Nutricional Enteral do Paciente Oncológico

“…Há de se ressaltar que pacientes oncológicos, pela fisiopatologia da doença, tendem a ser menos tolerantes a elevados volumes de dieta. Pois, os fatores pró-anoréticos, interleucinas 1 e 6, e o fator de necrose tumoral alfa podem reduzir a ingestão calórica e, aliados a fatores produzidos pelo tumor (de mobilização de proteínas e de imobilização de lipídeos), alicerçam a cascata de perda de peso nesses pacientes 20 .…”

Nutritional screening through patient-generated subjective global assessment (PG-SGA) in gynecological cancer

“…O que torna importante a utilização de outros métodos de avaliação como a ASG-PPP que possui maior sensibilidade em pacientes com câncer 23,24 . Santos et al 25 ao avaliarem 366 pacientes com câncer, observaram em amostra de 32 mulheres com câncer ginecológico, percentual de desnutrição em torno de 44% através da ASG-PPP. Enquanto a versão Tailandesa desta ferramenta identificou que 76% das pacientes com tumores ginecológicos estavam desnutridas 26 .…”