Clinical nutrition ESPEN · 2025
OncoNutridos study: Prevalence of disease-related malnutrition according to GLIM criteria in cancer patients in oncohaematology day hospitals.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ripa Carmen, Olariaga Olatz, Vallinas Sara, Sirvent Mariola, Prado Elena, Romero Rosa, Pérez Laia, Terroba Paloma, Hernández Sara, Chica Amelia, Gandara Maria José, Bourgon Lucrecia, Ochagavia Maria, Tamayo Rocío, Leunda Larraitz
Аннотация
BACKGROUND & AIMS: Disease-related malnutrition (DRM) is a frequent condition among cancer patients, with prevalence varying widely across studies depending on the phase of the disease (e.g., at diagnosis, during advanced stages, or throughout antineoplastic treatment) and tumour location. The aim of the OncoNutridos study was to assess the prevalence of DRM using the Global Leadership Initiative on Malnutrition (GLIM) criteria in cancer patients receiving active antineoplastic treatment in oncohaematology day hospitals. Additionally, the study evaluated the relationship between DRM and cancer-related hospital admissions, as well as 6-month mortality following study inclusion.
METHODS: This was a national, cross-sectional, observational, multicentre study conducted in accordance with standard clinical practice. Demographic characteristics, comorbidities, clinical variables, and anthropometric data were collected at the time of patient's admission to the chemotherapy suite. Anthropometric data -weight (kg) and height (m)- were obtained from the patient's medical record. Usual weight was obtained through patient's interview. DRM was diagnosed in accordance with the GLIM criteria. Reduced muscle mass was assessed via calf circumference -adjusted for the patient's BMI-. All patients were interviewed to detect reduced food intake. Patient recruitment took place across eight months, with a follow-up period of six months thereafter.
RESULTS: A total of 4440 patients were included between 86 hospitals nationwide. The median age was 61.1 years, 71.8 % of the patients were under 70 years of age, and 72.3 % were in advanced tumour stage (III-IV). The overall prevalence of disease-related malnutrition (DRM) according to GLIM criteria was 50.74 % (45.98 % in patients <70 years, and 62.86 % in those ≥70 years). Malnutrition prevalence was significantly higher among patients with advanced-stage tumours (stage III-IV) compared to those in early-stage disease (stage I-II) (54 % vs. 42 %; p < 0.001). Among patients with DRM, 72.52 % had moderate malnutrition, with no significant differences in malnutrition severity observed between age groups. Additionally, 77.2 % of malnourished patients were in advanced stages of disease (Stage III-IV). Compared to well-nourished individuals, malnourished patients had a significantly higher incidence of oncology-related hospitalizations in the six months following recruitment (36.8 % vs 31.32 %; p < 0.001; RR 1.18 IC95 % [1.08; 1.28]). Additionally, a higher percentage of deaths in the 6 months after the inclusion was detected in the group of patients with malnutrition (15.74 % vs 8.37 %; p < 0.001; RR 1.88 IC95 % [1.58; 2.23]).
CONCLUSION: Given the high prevalence of malnutrition observed across all tumour types, cancer stages and age groups, early identification and timely nutritional intervention should be prioritized. The demonstrated impact of disease-related malnutrition on clinical outcomes underscores the need to integrate nutritional care as a key component of the comprehensive management of oncology patients.
METHODS: This was a national, cross-sectional, observational, multicentre study conducted in accordance with standard clinical practice. Demographic characteristics, comorbidities, clinical variables, and anthropometric data were collected at the time of patient's admission to the chemotherapy suite. Anthropometric data -weight (kg) and height (m)- were obtained from the patient's medical record. Usual weight was obtained through patient's interview. DRM was diagnosed in accordance with the GLIM criteria. Reduced muscle mass was assessed via calf circumference -adjusted for the patient's BMI-. All patients were interviewed to detect reduced food intake. Patient recruitment took place across eight months, with a follow-up period of six months thereafter.
RESULTS: A total of 4440 patients were included between 86 hospitals nationwide. The median age was 61.1 years, 71.8 % of the patients were under 70 years of age, and 72.3 % were in advanced tumour stage (III-IV). The overall prevalence of disease-related malnutrition (DRM) according to GLIM criteria was 50.74 % (45.98 % in patients <70 years, and 62.86 % in those ≥70 years). Malnutrition prevalence was significantly higher among patients with advanced-stage tumours (stage III-IV) compared to those in early-stage disease (stage I-II) (54 % vs. 42 %; p < 0.001). Among patients with DRM, 72.52 % had moderate malnutrition, with no significant differences in malnutrition severity observed between age groups. Additionally, 77.2 % of malnourished patients were in advanced stages of disease (Stage III-IV). Compared to well-nourished individuals, malnourished patients had a significantly higher incidence of oncology-related hospitalizations in the six months following recruitment (36.8 % vs 31.32 %; p < 0.001; RR 1.18 IC95 % [1.08; 1.28]). Additionally, a higher percentage of deaths in the 6 months after the inclusion was detected in the group of patients with malnutrition (15.74 % vs 8.37 %; p < 0.001; RR 1.88 IC95 % [1.58; 2.23]).
CONCLUSION: Given the high prevalence of malnutrition observed across all tumour types, cancer stages and age groups, early identification and timely nutritional intervention should be prioritized. The demonstrated impact of disease-related malnutrition on clinical outcomes underscores the need to integrate nutritional care as a key component of the comprehensive management of oncology patients.