a Department of Medical Oncology , Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon-IC-HCL, University of Lyon 1 , Pierre-Bénite , France.
b Department of Respiratory Medicine , Centre Hospitalier Lyon-Sud, University of Lyon 1 , Pierre-Bénite , France.
Nutr Cancer. 2019;71(6):971-980. doi: 10.1080/01635581.2019.1595051. Epub 2019 May 9.
To assess how physicians and surgeons carried out malnutrition screening and follow-up for patients with lung cancer. We carried out an expert opinion survey in France using an anonymous self-administered online questionnaire. In 2017, 206 practitioners responded, of which 60.7% were pulmonologists, 17.4% thoracic surgeons, 11.2% oncologists, and 10.7% radiotherapists. At initial diagnosis, 79.3% of practitioners recorded patients' percentage of weight loss. During follow-up examinations, 67.5% recorded this data for patients at risk of malnutrition and 70.4 % for malnourished patients. Food intake was evaluated by 21.7% of practitioners at initial diagnosis. Surgeons assessed percentage of weight loss and food intake significantly less often than pulmonologists did, they were less likely to request serum albumin tests and waited for a greater percentage of weight loss before referring patients to a nutrition professional. All practitioners were well aware of the prevalence of malnutrition among lung cancer patients and its consequences. The main factors preventing optimal nutritional assessment reported by practitioners were a lack of time and limited specialized knowledge. Nutritional assessment remained suboptimal, especially for surgical patients. The importance granted to malnutrition needs to be increased for patients with lung cancer, especially in surgical departments. Highlights Physicians and thoracic surgeons are well aware of the prevalence and consequences in lung cancer patients. Thoracic surgeons seemed to be less sensitized to malnutrition screening than pulmonologists. Lack of time and limited specialized knowledge were reported as the main factors preventing optimal nutritional assessment.
评估医生和外科医生对肺癌患者进行营养不良筛查和随访的情况。我们在法国进行了一项专家意见调查，采用匿名在线问卷调查。2017 年，有 206 名从业者做出了回应，其中 60.7%为肺病专家，17.4%为胸外科医生，11.2%为肿瘤学家，10.7%为放射治疗师。在初始诊断时，79.3%的从业者记录了患者体重减轻的百分比。在随访检查中，67.5%的从业者记录了有营养不良风险的患者的数据，70.4%的从业者记录了营养不良患者的数据。21.7%的从业者在初始诊断时评估了食物摄入量。外科医生评估体重减轻和食物摄入量的频率明显低于肺病专家，他们不太可能要求进行血清白蛋白检测，并且在将患者转介给营养专家之前，等待体重减轻的比例更大。所有从业者都非常清楚肺癌患者营养不良的普遍程度及其后果。从业者报告的阻止进行最佳营养评估的主要因素是缺乏时间和有限的专业知识。营养评估仍然不尽如人意，特别是对于手术患者。需要增加肺癌患者对营养不良的重视，尤其是在胸外科部门。重点肺病专家和胸外科医生非常清楚肺癌患者中营养不良的普遍性和后果。胸外科医生似乎比肺病专家对营养不良筛查的敏感性较低。缺乏时间和有限的专业知识被报告为阻止最佳营养评估的主要因素。
