Assessing Risk of Malnutrition Can be Done on the First Visit With a Nurse
Malnutrition is a potentially fatal adverse event that many patients undergoing treatment for cancer will face, but it's an adverse event that can be dealt with ahead of time during the first visit with an oncology nurse.
For many patients with cancer, malnutrition is a potentially fatal adverse event (AE) during the course of treatment that can be directly responsible for death in approximately 20% of cases, according to research presented at the European Society of Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.
Researchers from the medical oncology section at Donostia University Hospital in San Sebastian, Spain, a part of the Oskidetza institution, wanted to find a way to work ahead of malnutrition in the very first consultation with an oncology nurse by identifying key factors related to a higher probability of the AE occurring.
To do this, researchers set out to create a standardized nursing assessment using a malnutrition screening tool (MST) along with data such as tumor and patient type, body mass index (BMI), specific changes in diet, ECOG score, and the oncological treatment prescribed and whether or not that treatment was the standard or reduced dose.
Based on their findings, they found it to be a useful tool to asses a patient’s nutrition and identify patients that needed a nutritional intervention at the start of their treatment.
Utilizing their standardized assessment, the researchers looked at the first nursing visit of 410 patients between July 1, 2017, and May 1, 2018, and put patients into 2 distinct groups based on their nutritional status — MST<2 and MST>=2. Those with MST>2 were considered to have more signs of malnutrition than patients with MST<2. Sixty-five percent of the patients in MST>2 group were male compared to only 41% of the MST<2 group, showing that simple intake data such as sex plays a role in predicting possible malnutrition.
Patients with MST>2 also showed early signs of needing a nutritional intervention to help quality of life versus those with MST<2. For example, for patients with MST>2, 86% had an ECOG performance score of 3, whereas 77% of MST<2 patients had an ECOG score of 0, highlighting that patients with cancer experiencing malnutrition already need special attention to their quality of life.
Patients with a higher MST were also associated with more reduced treatment doses versus patients with lower MST. The researchers also highlighted that MST>2 status was associated with diets consisting of solid food, being older, and lung tumors or gastrointestinal tumors. The researchers also noted that the difference in sex in tumor distribution was explained by the prevalence of tumor type in each sex rather than MST status.
Valverde Citores A, Uranga Garciarena E, Agirre Odiago G, et al. Identification of Malnutrition Risk Factors in Patients With Cancer in the First Nursing Visit. Presented at 2019 ESMO Congress; September 27-October 2, 2019; Barcelona, Spain.