Training and Research Department, National Tumor Assistance (ANT) Foundation, Via Jacopo di Paolo, 36-40128 Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy.
Nutrients. 2022 Oct 14;14(20):4307. doi: 10.3390/nu14204307.
Malnutrition is one of the main factors determining cachexia syndrome, which negatively impacts the quality of life and survival. In cancer patients, artificial nutrition is considered as an appropriate therapy when the impossibility of an adequate oral intake worsened nutritional and clinical conditions. This study aims to verify, in a home palliative care setting for cancer patients, if home artificial nutrition (HAN) supplies a patient's energy requirement, improving nutritional and performance status. A nutritional service team performed counseling at a patient's home and assessed nutritional status (body mass index, weight loss in the past 6 months), resting energy expenditure (REE), and oral food intake; Karnofsky Performance Status (KPS); cachexia degree; and survival. From 1990 to 2021, 1063 patients started HAN. Among these patients, 101 suspended artificial nutrition for oral refeeding. Among the 962 patients continuing HAN until death, 226 patients (23.5%) survived 6 weeks or less. HAN allowed to achieve a positive energy balance in 736 patients who survived more than 6 weeks, improving body weight and KPS when evaluated after 1 month of HAN. Advanced cancer and cachexia degree at the entry of the study negatively affected the positive impact of HAN.
营养不良是导致恶病质综合征的主要因素之一，它会降低生活质量和生存率。在癌症患者中，当无法通过口服摄入足够的营养来改善营养和临床状况时，人工营养被认为是一种适当的治疗方法。本研究旨在验证在癌症患者的家庭姑息治疗环境中，家庭人工营养（HAN）是否能够满足患者的能量需求，从而改善营养和身体状况。营养服务团队在患者家中进行咨询，并评估营养状况（体重指数、过去 6 个月的体重减轻）、静息能量消耗（REE）和口服食物摄入量；卡诺夫斯基表现状态（KPS）；恶病质程度；以及生存率。1990 年至 2021 年期间，共有 1063 名患者开始接受 HAN。其中，101 名患者因口服喂养而暂停人工营养。在继续接受 HAN 直至死亡的 962 名患者中，有 226 名（23.5%）患者在 6 周或更短时间内存活。HAN 使 736 名存活时间超过 6 周的患者实现了正能平衡，改善了体重和 KPS，这是在接受 HAN 治疗 1 个月后评估的结果。晚期癌症和研究开始时的恶病质程度会对 HAN 的积极影响产生负面影响。
