Hébuterne Xavier, Lemarié Etienne, Michallet Mauricette, de Montreuil Claude Beauvillain, Schneider Stéphane Michel, Goldwasser François
Gastroenterology and Clinical Nutrition, Nice Teaching Hospital (CHU), University of Nice Sophia-Antipolis, Nice.
JPEN J Parenter Enteral Nutr. 2014 Feb;38(2):196-204. doi: 10.1177/0148607113502674.
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.
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.
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.
The prevalence of malnutrition is high in patients with cancer, and systematic screening for and treatment of malnutrition is necessary.
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。
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。
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。
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。
