Introduction:
Malnutrition is an important supportive care need for people with cancer. The Patient Generated–Subjective Global Assessment (PG-SGA) is a validated tool to determine malnutrition in cancer patients.
Objectives:
The aims of this study were (1) to determine the prevalence of malnutrition using the PG-SGA for inpatients and ambulatory patients receiving chemotherapy and/or radiotherapy, (2) to identify the proportion of malnourished patients receiving dietetic intervention and (3) determine the association between malnutrition and clinical outcomes.
Methods:
In March 2012, a point prevalence malnutrition study of adult cancer patients was conducted in 15 Health Services in Victoria. The patients were included from both inpatient and ambulatory settings. Outcomes were collected at day 30.
Results:
A total of 1693 cancer patients were included, with 31% (n=523) identified as malnourished. Malnutrition prevalence of inpatients was 57% (191 of 336) and 25% of ambulatory patients (332 of 1357) receiving radiotherapy and/or chemotherapy. Malnutrition prevalence was higher in patients with tumours of the upper gastro-intestinal tract (62%), head & neck (40%) and lung (37%) but present in all tumour streams. Of those patients identified as malnourished only 56% were receiving dietetic intervention.
Length of stay was significantly longer for malnourished inpatients when compared to well-nourished inpatients (20.3 vs 15.7 days, p<0.001). All patients with malnutrition had a significantly higher 30-day mortality (6% vs 1%, p<0.001) and rate of hospital admission rate (38% vs 12%, p<0.001).
Conclusions:
Malnutrition prevalence in cancer patients is dependent on tumour type and treatment modality and is associated with increased length of stay, mortality and unplanned hospital admissions. Identification and treatment of malnutrition with validated screening and assessment tools is essential to ensure patients receive appropriate and timely dietetic intervention.