Nutritional Risk and Assessment for Patients with Cancer Pain

Abstract

Background

The incidence of nutritional risk and malnutrition are high in patients with cancer pain. It is very important to choose an effective tool to identify these patients promptly. However, few studies have discussed this issue. The primary objective of this study is to clarify the similarities and differences between the two nutritional screening and assessment tools, and to estimate the anthropometry and biochemical indicators of the patients with cancer pain, with a view to provide help for treatment of these patients.

Method

Data of 146 patients with cancer pain were collected from August 2018 to May 2019 in the Pain Therapy Department of Tianjin Cancer Hospital. The information of numerical rating scale (NRS), nutritional risk screening-2002 (NRS-2002), patient-generated subjective global assessment (PG-SGA), anthropometry and biochemical indicators were collected for pain assessment, nutritional risk screening, and nutritional status assessment.

Results

NRS scores had a positive correlation with NRS-2002 (R = 0.273, P = 0.001) and PG-SGA (R = 0.341, P = 0.000) separately. NRS-2002 and PG-SGA had a significant positive correlation with each other (R = 0.468, P = 0.000). NRS-2002 was finished in a shorter time period (4.2 ± 0.8 min vs. 12.8 ± 0.8 min, P = 0.001), while PG-SGA had a higher detection rate of malnutrition (86.3% vs. 65.8%). In the stepwise multiple regression analysis, NRS (0.258, P = 0.001), PA (−0.297, P = 0.000), TP (0.178, P = 0.030) are the indicators of NRS-2002; and NRS (0.317, P = 0.000), PA (β = 0.288, P = 0.000) and BMI (−0.281, P = 0.000) are the related variables of PG-SGA. The kappa coefficient was lower than 0.4 (kappa value = 0.396) when choosing the score of NRS-2002 ≥ 3 and PG-SGA ≥ 9 as the diagnostic criteria. If choosing the score of NRS-2002 ≥ 2 and PG-SGA ≥ 9, both the correlation coefficient (R = 0.699, P = 0.000) and the kappa coefficient (kappa value = 0.698, P = 0.000) became more coefficient.

Conclusions

Both NRS-2002 and PG-SGA could identify patients with nutritional risk and malnutrition accurately. NRS-2002 is simpler and takes less time to finish, while PG-SGA is more cumbersome with a higher detection rate of malnutrition. NRS, PA, TP and BMI are the most important reference indicators predicting on nutritional risk index and malnutrition status. We recommend NRS-2002 ≥ 2 as the diagnostic criteria in order to avoid missing the patients with nutritional risk.

Acknowledgments

The authors gratefully thank all of the participants in this study and Tianjin Medical University Cancer Institute and Hospital for supporting this study.

Authors’ Contributions

YJC and KW contributed to the conception and the design of this study; QX, CLL, YQZ, JD, YYL, PZ, and YJW, collected, analyzed, and interpreted the data; YJC and QX drafted the manuscript and revised the manuscript. All authors agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approve the final manuscript.

Data Availability Statement

The datasets used and analyzed during the present study are available from the corresponding author upon reasonable request.

Disclosure Statement

The authors declare that they have no conflict of interest. The manuscript has been submitted solely to this journal and is not published, in press, or currently submitted elsewhere.

Ethics Approval and Consent to Participate

Written informed consent was obtained from all participants, and the study was approved and supervised by the Ethics Committee of the Tianjin Medical University Cancer Institute and Hospital.

Funding

No funding was obtained for this study.