Li Zijian, Chen Wei, Li Hailong, Zhao Bin
Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Pharmacy Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Asia Pac J Clin Nutr. 2018;27(6):1216-1224. doi: 10.6133/apjcn.201811_27(6).0007.
Malnutrition has adverse impacts on survival of cancer patients. The aim of the present study was to investigate the prevalence of malnutrition, and the nutrition support status in hospitalized patients with cancer in China.
A multi-center, cross-sectional study was conducted in 29 tertiary public hospital wards in 14 Chinese cities. Malnutrition was defined as weight loss (WL) >5% over the past 6 months or body mass index (BMI) <20 kg/m2 with WL >2%. The nutrition risk index (NRI) and performance status (PS) were evaluated.
1138 hospitalized cancer patients (93.4% of the initial sample, 662 men, 60.6±14.5 years) were enrolled. Overall, 41.3% of patients were malnourished. The percentage of nutritional disorders as determined by the NRI was 51.4%. PS was 0 in 50.3%, 1 in 15.4%, 2 in 13.9%, and 3 or 4 in 20.4%. Compared with patients with PS of 0-1, patients with PS of 3-4 had a relative risk of malnutrition of 1.275 (95% CI 0.250-0.488, p<0.0001). Only 38.6% of patients received nutrition support, of whom 45.0% of the malnourished and 31.9% of the non-malnourished patients did; 63.2% of patients complained of poor appetite, while merely 14.0% of patients had received nutrition counseling.
The prevalence of malnutrition is high in hospitalized cancer patients, and inappropriate use of nutritional interventions highlights the urgent need to define standard operating procedures and quality control process.
营养不良对癌症患者的生存有不利影响。本研究旨在调查中国住院癌症患者中营养不良的患病率及营养支持状况。
在14个中国城市的29个三级公立医院病房进行了一项多中心横断面研究。营养不良定义为过去6个月体重减轻(WL)>5%或体重指数(BMI)<20kg/m²且体重减轻>2%。评估了营养风险指数(NRI)和体能状态(PS)。
纳入了1138例住院癌症患者(占初始样本的93.4%,男性662例,年龄60.6±14.5岁)。总体而言,41.3%的患者存在营养不良。根据NRI确定的营养障碍百分比为51.4%。PS为0的患者占50.3%,为1的占15.4%,为2的占13.9%,为3或4的占20.4%。与PS为0 - 1的患者相比,PS为3 - 4的患者发生营养不良的相对风险为1.275(95%CI 0.250 - 0.488,p<0.0001)。仅38.6%的患者接受了营养支持,其中45.0%的营养不良患者和31.9%的非营养不良患者接受了营养支持;63.2%的患者抱怨食欲不佳,而仅有14.0%的患者接受了营养咨询。
住院癌症患者中营养不良的患病率较高,营养干预的不当使用凸显了定义标准操作程序和质量控制流程的迫切需求。