Malnutrition Risk Is Associated With All-Cause Mortality and Chemotherapy Complications Among Adults Diagnosed With Diverse Cancer Types: A Retrospective Cohort Study.

BACKGROUND

Studies investigating the association of malnutrition with mortality and complications of cancer treatment in oncology patients are primarily restricted to head and neck and gastrointestinal cancers. Yet, malnutrition risk factors are experienced across cancer types.

OBJECTIVE

To evaluate the association of malnutrition risk, assessed by the Malnutrition Screening Tool, with all-cause mortality and complications of chemotherapy and radiation among oncology patients.

DESIGN

A retrospective cohort study using electronic medical record data from January 2021 to April 2024.

PARTICIPANTS/SETTING: Two thousand eight hundred fifty-nine adult cancer patients with a Malnutrition Screening Tool score within 1 year of a cancer diagnosis were included. Patients were treated at 9 outpatient clinics in the western United States.

MAIN OUTCOME MEASURES

The primary outcome was all-cause mortality. Secondary outcomes were complications of chemotherapy and radiation.

STATISTICAL ANALYSIS PERFORMED

Cox proportional hazards regression, adjusted for key confounders, was used to evaluate the association of malnutrition risk with time to death from any cause. A secondary analysis stratified by cancer type was conducted when sample size permitted. Multivariable logistic regression was used to assess the association of malnutrition risk with the first treatment-related complication.

RESULTS

Malnutrition risk, compared with no risk, was significantly associated with increased risk for all-cause mortality for all cancer patients combined (hazard ratio 1.70; 95% CI, 1.39-2.07; P < .001) and some specific cancer types, such as lung cancer (hazard ratio 1.58; 95% CI, 1.05 to 2.37; P = .03). Malnutrition risk was also associated with increased likelihood of complications of chemotherapy in all cancers combined (odds ratio 1.49; 95% CI, 1.11-2.00; P < .01).

CONCLUSIONS

Malnutrition risk was associated with elevated risk of mortality and chemotherapy complications for all cancers combined. These results highlight the importance of malnutrition risk in cancer prognosis.