Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands.
Department of Medical Oncology, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands.
Support Care Cancer. 2018 Jun;26(6):2039-2047. doi: 10.1007/s00520-018-4044-1. Epub 2018 Jan 19.
Patients with colorectal cancer (CRC) often experience malnutrition and weight loss, largely resulting from reduced dietary intake. The aim of this study was to identify determinants of reduced dietary intake in order to facilitate early recognition of malnutrition and optimise nutritional treatment.
Data from nutritionDay, an international 1-day survey investigating patient, disease and food profiles, were used. To identify determinants of dietary intake, defined as normal vs. reduced in the last week, univariate and multivariate logistic regressions were performed.
Of 1131 hospitalised CRC patients, 54% reported reduced dietary intake. Patient- and disease-related characteristics significantly associated with reduced dietary intake were female gender (odds ratio (OR) 1.38), cancer stage III (OR 1.52) or IV (OR 1.70) vs. I, performance status 2 (OR 1.56), 3 (OR 2.37) or 4 (OR 4.15) vs. 0, duration since hospital admission of ≥ 4 days (OR 4-7 days, 1.91; 8-21 days, 1.97; > 21 days, 1.92) vs. < 4 days, and unintentional weight loss (OR 2.56). Additionally, higher symptom scores of pain, weakness, depression, tiredness and lack of appetite were associated with reduced intake.
Patient- and disease-related determinants for reduced dietary intake were being female, higher cancer stage, worse performance status, duration since hospital admission ≥ 4 days and unintentional weight loss. Furthermore, multiple symptoms were associated with a reduced dietary intake. Future trials should assess whether early recognition of patients at risk of malnutrition and the combination of treating symptoms and dietary advice result in improved intake and treatment-related outcomes.
结直肠癌（CRC）患者常出现营养不良和体重减轻，主要是由于饮食摄入减少所致。本研究旨在确定饮食摄入减少的决定因素，以便早期识别营养不良并优化营养治疗。
使用营养日（nutritionDay）的数据，这是一项国际为期 1 天的调查，研究患者、疾病和食物特征。为了确定饮食摄入的决定因素，将上周定义为正常和减少，进行了单变量和多变量逻辑回归分析。
在 1131 名住院 CRC 患者中，54%报告饮食摄入减少。与饮食摄入减少显著相关的患者和疾病相关特征为女性（优势比[OR]1.38）、癌症分期 III（OR 1.52）或 IV（OR 1.70）与 I 相比、体能状态 2（OR 1.56）、3（OR 2.37）或 4（OR 4.15）与 0 相比、住院时间≥4 天（OR 4-7 天，1.91；8-21 天，1.97；>21 天，1.92）与<4 天相比、以及非故意体重减轻（OR 2.56）。此外，疼痛、虚弱、抑郁、疲倦和缺乏食欲等症状评分较高与摄入减少有关。
与饮食摄入减少相关的患者和疾病相关决定因素为女性、癌症分期较高、体能状态较差、住院时间≥4 天和非故意体重减轻。此外，多种症状与饮食摄入减少有关。未来的试验应评估早期识别有营养不良风险的患者以及治疗症状和饮食建议相结合是否会改善摄入和与治疗相关的结局。
