Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
Nutr Cancer. 2023;75(3):923-936. doi: 10.1080/01635581.2023.2170431. Epub 2023 Jan 24.
More information is needed about the impact of outpatient nutrition care from a registered dietitian nutritionist (RDN) on patient outcomes. This study aimed to assess the feasibility of a cohort study design to evaluate impact of RDN nutrition care on patient outcomes, describe clinic malnutrition screening practices, and estimate statistical parameters for a larger study. Seventy-seven patients with lung, esophageal, colon, rectal, or pancreatic cancer from six facilities were included (41 received RDN care and 36 did not). RDN nutrition care was prospectively documented for six months and documented emergency room visits, unplanned hospitalizations and treatment changes were retrospectively abstracted from medical records. Most facilities used the Malnutrition Screening Tool (MST) to determine malnutrition risk. Patients receiving RDN care had, on average, five, half hour visits and had more severe disease and higher initial malnutrition risk, although this varied across sites. Documented medical and treatment outcomes were relatively rare and similar between groups. Estimated sample size requirements varied from 113 to 5856, depending on tumor type and outcome, and intracluster correlation coefficients (ICCs) ranged from 0 to 0.47. Overall, the methods used in this study are feasible but an interventional or implementation design might be advantageous for a larger study.
需要更多关于注册营养师（RDN）提供门诊营养护理对患者结局影响的信息。本研究旨在评估一项队列研究设计评估 RDN 营养护理对患者结局影响的可行性，描述临床营养不良筛查实践，并估计更大规模研究的统计参数。来自六个机构的 77 名患有肺癌、食管癌、结肠癌、直肠癌或胰腺癌的患者入组（41 名接受 RDN 护理，36 名未接受）。RDN 营养护理前瞻性记录 6 个月，并从病历中回顾性提取急诊就诊、非计划住院和治疗变更的记录。大多数机构使用营养不良筛查工具（MST）来确定营养不良风险。接受 RDN 护理的患者平均有五次半小时的就诊，且疾病更严重，初始营养不良风险更高，但各机构之间存在差异。记录的医疗和治疗结局相对较少，两组之间相似。根据肿瘤类型和结局，估计样本量需求从 113 到 5856 不等，组内相关系数（ICC）范围从 0 到 0.47。总体而言，本研究中使用的方法是可行的，但对于更大规模的研究，干预或实施设计可能更有利。
