The Impact of Nutritional Status, Nutritional Risk, and Nutritional Treatment on Clinical Outcome of 2248 Hospitalized Cancer Patients: A Multi-Center, Prospective Cohort Study in Chinese Teaching Hospitals

Abstract

To better understand the impact of undernutrition, nutritional risk, and nutritional treatment on the clinical outcomes of hospitalized cancer patients in China, the authors conducted a multicenter, cross-sectional study with 2248 cancer patients from 20 hospitals from January to June 2010. The authors defined 19.7% and 26.8% patients as undernourished at baseline and reassessment, respectively. Patients with gastrointestinal malignancies had a higher rate of undernutrition than other patients. The nutritional risk rate was 24.6% and 40.2% at baseline and reassessment, respectively. For patients with nutritional risk, the relative risk (RR) of adverse events (AEs) significantly increased with and without nutritional treatment. In comparison with the nonnutritional treatment subgroup, patients who received enteral nutrition (EN) or total parenteral nutrition (TPN) significantly reduced the RR of AE development. The RR of AEs for EN and TPN were 0.08 (95% CI: 0.01–0.62) and 0.56 (95% CI: 0.33–0.96), respectively. Separated nutrient infusion increased the risk of AEs. The authors concluded that undernutrition and nutritional risk are general problems that impact the outcomes of hospitalized cancer patients in China. Higher NRS2002 scores are related to AE risk but not weight loss. In nutritional treatment, EN and TPN can significantly reduce the risk of AEs.

ACKNOWLEDGMENTS

The work described above is financially supported by Chinese Society of Clinical Oncology. The authors are indebted to all the staffs for data collection at Sir Run Run Shaw Hospital, Hangzhou, China; Fudan University Shanghai Cancer Center, Shanghai, China; Beijing Cancer Hospital & Institute, Beijing, China; Jinling Hospital, Nanjing, China; Southwest Hospital, Chongqing, China; Guangdong General Hospital, Guangzhou, China; Military Bayi Hospital, Nanjing, China; Wenzhou No.1 Hospital, Wenzhou, China; First Affiliated Hospital of Soochow University, Suzhou, China; Jiangsu Cancer Hospital, Nanjing, China; General Hospital of Jiangsu Province, Nanjing, China; Nanjing No.1 Hospital, Nanjing; Zhejiang Cancer Hospital, Hangzhou, China; Liaoning Cancer Hospital, Shenyang, China; Chinese Academy of Medical Science Cancer Hospital, Beijing, China; Wuhan Union Hospital, Wuhan, China; Affiliated Hospital of Qingdao University, Qingdao, China; Shandong Cancer Hospital, Jinan, China; Xiamen Chang Gung Hospital, Xiamen, China; and Zhongda Hospital, Suzhou, China.