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癌症患者营养不良的患病率及目前营养支持的使用情况。

Prevalence of malnutrition and current use of nutrition support in patients with cancer.

作者信息

Hébuterne Xavier, Lemarié Etienne, Michallet Mauricette, de Montreuil Claude Beauvillain, Schneider Stéphane Michel, Goldwasser François

机构信息

Gastroenterology and Clinical Nutrition, Nice Teaching Hospital (CHU), University of Nice Sophia-Antipolis, Nice.

出版信息

JPEN J Parenter Enteral Nutr. 2014 Feb;38(2):196-204. doi: 10.1177/0148607113502674.

Abstract

BACKGROUND AND AIMS

The aim of this study was to evaluate on 1 day the prevalence of malnutrition in different types of cancer and the use of nutrition support in patients with cancer.

METHODS

A 1-day prevalence survey was carried out in 154 French hospital wards. Malnutrition was defined as a body mass index (BMI) <18.5 in patients <75 years old or <21 in patients ≥75 years old and/or body weight loss >10% since disease onset. Oral food intake was measured using a visual analog scale.

RESULTS

Nutrition status was collected for 1903 patients (1109 men and 794 women, 59.3 ± 13.2 years). Cancer was local in 25%, regional in 31%, and metastatic in 44% of patients. Performance status was 0 or 1 in 49.8%, 2 in 23.7%, 3 or 4 in 19.6% and not available in 6.5% of patients. Overall, 39% of patients were malnourished. The prevalence of malnutrition by disease site was as follows: head and neck, 48.9%; leukemia/lymphoma, 34.0%; lung, 45.3%; colon/rectum, 39.3%; esophagus and/or stomach, 60.2%; pancreas, 66.7%; breast, 20.5%; ovaries/uterus, 44.8%; and prostate, 13.9%. Regional cancer (odds ratio, 1.96; 95% confidence interval, 1.42-2.70), metastatic cancer (2.97; 2.14-4.12), previous chemotherapy (1.41; 1.05-1.89), and previous radiotherapy (1.53; 1.21-1.92) were associated with malnutrition. Only 28.4% of non-malnourished patients and 57.6% of malnourished patients received nutrition support. In all, 55% of patients stated that they were eating less than before the cancer, while 41.4% of patients stated that they had received nutrition counseling.

CONCLUSIONS

The prevalence of malnutrition is high in patients with cancer, and systematic screening for and treatment of malnutrition is necessary.

摘要

背景与目的

本研究旨在评估不同类型癌症患者营养不良的1日患病率以及癌症患者营养支持的使用情况。

方法

在154个法国医院病房开展了一项为期1天的患病率调查。营养不良定义为年龄小于75岁的患者体重指数(BMI)<18.5,或年龄≥75岁的患者BMI<21,和/或自疾病发作以来体重减轻>10%。使用视觉模拟量表测量口服食物摄入量。

结果

收集了1903例患者(1109例男性和794例女性,年龄59.3±13.2岁)的营养状况。25%的患者癌症为局部性,31%为区域性,44%为转移性。49.8%的患者体能状态为0或1,23.7%为2,19.6%为3或4,6.5%的患者未提供体能状态信息。总体而言,39%的患者存在营养不良。按疾病部位划分的营养不良患病率如下:头颈部,48.9%;白血病/淋巴瘤,34.0%;肺癌,45.3%;结肠/直肠癌,39.3%;食管和/或胃癌,60.2%;胰腺癌,66.7%;乳腺癌,20.5%;卵巢/子宫癌,44.8%;前列腺癌,13.9%。区域性癌症(比值比,1.96;95%置信区间,1.42 - 2.70)、转移性癌症(2.97;2.14 - 4.12)、既往化疗(1.41;1.05 - 1.89)和既往放疗(1.53;1.21 - 1.92)与营养不良相关。只有28.4%的非营养不良患者和57.6%的营养不良患者接受了营养支持。总体而言,55%的患者表示他们的进食量比患癌前减少,而41.4%的患者表示他们接受过营养咨询。

结论

癌症患者中营养不良的患病率很高,因此有必要对营养不良进行系统筛查和治疗。

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