Identification of Malnutrition Risk Factors in Gastrointestinal Cancer: A Multicentric Cross-Sectional Study.

BACKGROUND

Malnutrition is highly prevalent among gastrointestinal (GI) cancer patients and is associated with poor clinical outcomes. Early identification of nutritional risk is essential to optimize patient care prior to treatment initiation.

OBJECTIVE

To assess the prevalence of malnutrition using Patient-Generated Subjective Global Assessment (PG-SGA) and examine its association with demographic, clinical, anthropometric, and dietary intake as risk factors in newly diagnosed, treatment naïve GI cancer patients.

METHODS

A cross-sectional study was conducted in Coimbatore, Tamil Nadu, involving 181 patients. Nutritional status was assessed using PG SGA, anthropometry, and a 3-day 24-hour dietary recall. Statistical analysis included Chi-square, ANOVA and logistic regression.

RESULTS

Malnutrition was identified in 73.5% of patients. Significant associations were found between malnutrition and stage of cancer (p ˂0.001), tumour site (p=0.001), symptom burden (p ˂0.001), and increased nutritional needs (p ˂0.001). Malnourished patients had significantly lower energy and protein intake (p ˂0.001). Independent predictors of malnutrition included low BMI (OR: 0.509, 95% CI: 0.335-0.773, p=0.002), weight loss percentage in six months (OR; 3.019, 95% CI: 1.509-6.039, p=0.002), inadequate energy intake (OR=23.036, 95% CI: 7.304-72.654, p˂0.001) and protein intake (OR=49.029, 95% CI: 6.200-87.69, p˂0.001), symptom burden (OR: 0.162, 95% CI: 0.090-0.244, p˂0.001), increased nutritional needs (OR: 0.301, 95% CI: 0.238-0.380, p˂0.001), advanced stage of cancer (OR=0.550, 95% CI: 0.478-0.634, p˂0.001).

CONCLUSION

A high prevalence of malnutrition was found among newly diagnosed GI cancer patients, driven by both clinical and nutritional factors. Early assessment and targeted intervention, especially focusing on dietary intake and symptom management, are crucial to improve clinical outcomes.