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2015, Number 1

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RCAN 2015; 25 (1)

Postsurgical nutritional status of cancer patient on admission to a critical care unit

Gutiérrez NA, Martos BFD, Echeverría VA, Pupo SY, Soto GA, Alonso RL, Linares RAL, Blanco FR

Language: Spanish
References: 65
Page: 60-75
PDF size: 431.18 Kb.


ABSTRACT

Rationale: Undernutrition affects 15–40% of cancer patients when diagnosis, as well as 80% of those in advanced stages of the disease. Nutritional assessment should identify states of malnutrition, establish risk of developing it at any moment during the course of this illness, reveal patients requiring nutritional treatment, and assess response to nutritional replenishment. Objective: To describe relationship between post-surgical nutritional status of cancer patient when admitted to a Critical Care Unit (CCU) and undesirable events. Study design: Observational, prospective, analytical. Material and method: CONUT score was calculated from biochemical indicators of nutritional status measured in 131 patients (Men: 51.9%; Ages ≥ 60 years: 58.8%; CCU length of stay: 5.6 ± 5.8 days) cared for at the CCU, Oncology and Radiobiology Institute (Havana City, Cuba) after being operated upon due to tumors of lung, esophagus and stomach, and colon, rectum, anus and anal canal. Results: Rate of undesirable events during CCU stay was 12.9%. CCU mortality rate was 9.2%. Frequency of malnutrition on CCU admission was 59.5%: Serum albumin ‹ 30.0g.L-1: 42.0%; Serum Total Cholesterol ‹ 3.0 mmol.L-1: 53.4%; and Lymphocytes Total Count (LTC) ‹ 1,200 cells.mL-1: 33.6%; respectively. Sixty-six point four percent of studied patients showed CONUT scores ‹ 5. CONUT score was associated with length of stay. Conclusions: CONUT score might signal those with prolonged stay in a CCU.


REFERENCES

  1. Barker LA, Gout BS, Crowe TC. Hospital malnutrition: Prevalence, identification and impact on patients and the healthcare system. Int J Environm Res Public Health 2011;8:514-27.

  2. Ocón J, Celaya S. Implicaciones clínicas de la desnutrición hospitalaria. En: Libro blanco de la desnutrición clínica en España [Editores: García de Lorenzo A, García Luna PP, Marsé P, Planas M]. Editorial Aula Médica. Madrid: 2004. pp. 61-70.

  3. Norman K, Pichard C, Lochs H, Pirlich, M. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27:5-15.

  4. Waitzberg DL, Caiaffa WT, Correia MTID. Hospital Malnutrition: The Brazilian National Survey (IBRANUTRI): A study of 4000 patients. Nutrition 2001;17:573-80.

  5. Correia MITD, Campos ACL. Prevalence of hospital malnutrition in Latin America: The Multicenter ELAN Study. Nutrition 2003;19:823-5.

  6. Barreto Penié J, for the Cuban Group for the Study of Hospital Malnutrition. State of malnutrition in Cuban hospitals. Nutrition 2005;21:487-97.

  7. Barreto Penié J, Santana Porbén S, Martínez González C, Espinosa Borrás A. Desnutrición hospitalaria: La experiencia del Hospital “Hermanos Ameijeiras”. Acta Médica Hospital Hermanos Ameijeiras 2003;11:76-95.

  8. Socarrás Suárez MM, Bolet Astoviza M, Fernández Rodríguez T, Martínez Manríquez JR, Muñoz Caldas L, Companioni J. Desnutrición hospitalaria en el hospital universitario “Calixto García”. Rev Cubana Invest Bioméd 2004;23:227-34.

  9. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 2005;9: S51-S63.

  10. von Meyenfeldt M. Cancer-associated malnutrition: An introduction. Eur J Oncol Nurs 2005;9:S35-S38.

  11. Chon Rivas I, Chi Ramírez D, León González R, Blanco Bouza J, Cuevas Véliz I, Rodríguez Abascal A, et al. La importancia del estado nutricional para el paciente oncológico. RCAN Rev Cubana Aliment Nutr 2009;19:133-45.

  12. Laviano A, Meguid MM, Rossi-Fanelli F. Cancer anorexia: Clinical implications, pathogenesis, and therapeutic strategies. The Lancet Oncology 2003;4:686-94.

  13. Bozzetti F; for the SCRINIO Working Group. Screening the nutritional status in oncology: A preliminary report on 1,000 outpatients. Support Care Cancer 2009; 17:279-84.

  14. Langer CJ, Hoffman JP, Ottery FD. Clinical significance of weight loss in cancer patients: rationale for the use of anabolic agents in the treatment of cancer-related cachexia. Nutrition 2001; 17:S1-S21.

  15. Huhmann MB, Cunningham RS. Importance of nutritional screening in treatment of cancer-related weight loss. The Lancet Oncol 2005;6:334-43.

  16. Fouladiun M, Körner U, Bosaeus I, Daneryd P, Hyltander A, Lundholm KG. Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care- Correlations with food intake, metabolism, exercise

  17. capacity, and hormones. Cancer 2005; 103:2189-98.

  18. Shizgal HM. Body composition of patients with malnutrition and cancer. Summary of methods of assessment. Cancer 1985;55(S1):250-3.

  19. Cao DX, Wu GH, Zhang B, Quan YJ, We J, Jin H; et al. Resting energy expenditure and body composition in patients with newly detected cancer. Clin Nutr 2010;29:72-7.

  20. de Ulibarri Pérez JI. Clinical undernutrition in 2014; pathogenesis, early diagnosis and consequences; undernutrition and trophopathy. Nutrición Hospitalaria [España] 2014; 29:785-96.

  21. Tisdale MJ. Cancer anorexia and cachexia. Nutrition 2001;17:438-42.

  22. Theologides A. Cancer cachexia. Curr Concepts Nutr 1997;6:75-94.

  23. Culebras JM. Malnutrition in the twenty-first century: An epidemic affecting surgical outcome. Surgical Infections 2013;14:237-43.

  24. Valenzuela Landaeta K, Rojas P, Basfifer K. Evaluación nutricional del paciente con cáncer. Nutrición Hospitalaria [España] 2012;27:516-23.

  25. Davies M. Nutritional screening and assessment in cancer-associated malnutrition. Eur J Oncol Nurs 2005;9: S64-S73.

  26. Gómez Candela C, Olivar Roldán J, García M, Marín M, Madero R, Pérez Portabella C; et al. Utilidad de un método de cribado de malnutrición en pacientes con cáncer. Nutrición Hospitalaria [España] 2010;25:400-5.

  27. Pablo AR, Izaga MA, Alday LA. Assessment of nutritional status on hospital admission: Nutritional scores. Eur J Clin Nutr 2003;57:824-31.

  28. Campillo B, Paillaud E, Uzan I, Merlier I, Abdellaoui M, Perennec J; et al. Value of body mass index in the detection of severe malnutrition: influence of the pathology and changes in anthropometric parameters. Clin Nutr 2004;23:551-9.

  29. Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 2010;16:3310-9.

  30. Mullen JT, Davenport DL, Hutter MM, Hosokawa PW, Henderson W G, Khuri SF, Moorman DW. Impact of body mass index on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery. Ann Surg Oncol 2008;15:2164-72.

  31. Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, Jeejeebhoy KH. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987;11: 8-13. Reimpreso después en: Nutrición Hospitalaria [España] 2008;23:395-407.

  32. Ottery FD. Rethinking nutritional support of the cancer patient: The new field of nutritional oncology. Sem Oncol 1994;21:770-8.32.

  33. Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996; 12:S15-S19.

  34. Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 2002;56:779-85.

  35. Isenring E, Bauer J, Capra S. The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radio-therapy. Eur J Clin Nutr 2003;57:305-9.

  36. Bauer J, Capra S. Comparison of a malnutrition screening tool with subjective global assessment in

  37. hospitalised patients with cancer-sensitivity and specificity. Asia Pacif J Clin Nutr 2003;12:257-60.

  38. Penel N, Lefebvre D, Fournier C, Sarini J, Kara A, Lefebvre JL. Risk factors for wound infection in head and neck cancer surgery: A prospective study. Head Neck 2001;23:447-55.

  39. Pacelli F, Bossola M, Rosa F, Tortorelli AP, Papa V, Doglietto GB. Is mal-nutrition still a risk factor of post-operative complications in gastric cancer surgery? Clin Nutr 2008;27:398-407.

  40. de Ulibarri Pérez JI, González-Madroño Giménez A, González Pérez P, Fernández G, Rodríguez Salvanés F, Mancha Álvarez-Estrada A, et al. Nuevo procedimiento para la detección precoz y control de la desnutrición hospitalaria. Nutrición Hospitalaria [España] 2002; 17:179-88.

  41. Santana Porbén S, Martínez Canalejo H. Manual de Procedimientos Bioestadísticos. Segunda Edición. EAE Editorial Académica Española. ISBN-13: 9783659059629. ISBN-10: 3659059625. Madrid: 2012.

  42. Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Nutritional deterioration in cancer: The role of disease and diet. Clin Oncol 2003;15:443-50.

  43. Donaldson SS, Lenon RA. Alterations of nutritional status. Impact of chemo-therapy and radiation therapy. Cancer 1979;43(S5):2036-52.

  44. Dewys WG, Begg C, Lavin PT; et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 1980;69:491-7.

  45. Tchekmedyian N. Cost and benefits of nutrition support in cancer. Oncology 1995;9(Suppl):S79-S84.

  46. Kamath SK, Lawter M, Smith AE, Kalat T, Olson R. Hospital malnutrition: A 33-hospital screening study. J Am Diet Assoc 1986;86:203-6.

  47. Cid Conde L, Fernández López T, Neira Blanco P, Arias Delgado J, Varela Correa JJ, Gómez Lorenzo FF. Prevalencia de desnutrición en pacientes con neoplasia digestiva previa cirugía. Nutrición Hospitalaria [España] 2008; 23:46-53.

  48. Segura A, Pardo J, Jara C; et al. An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastasic cancer. Clin Nutr 2005;24: 801-14.

  49. Nogueira JM. Prevalencia de la malnutrición en pacientes con cáncer: estudio NUPAC. Nutrición Clínica Dietética Hospitalaria [España] 2004; 24:17-18.

  50. León Pérez DO. Evaluación del estado nutricional de pacientes críticos en la sala de Terapia Intensiva del Hospital “Hermanos Ameijeiras”. Rev Cubana Med Intensiva Emergencias 2014; 13(4):0-0. Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/45. Fecha de última visita: 13 de Marzo del 2015.

  51. Santana Porbén S. Evaluación bioquímica del estado nutricional del paciente hospitalizado. Nutrición Clínica [México] 2003;6:293-311.

  52. Santana Porbén S. Utilidad de algunos indicadores bioquímicos del estado nutricional del paciente con enfermedad colorrectal maligna. Nutrición Clínica [México] 2006;9:5-12.

  53. Lohsiriwat V, Lohsiriwat D, Boonnuch W, Chinswangwatanakul V, Akaraviputh T, Lert-Akayamanee N. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery. World J Gastroenterol 2008;14:1248-57.

  54. Jurado JT, Pérez NPAT, Rodríguez AF. El valor predictivo de la albúmina en el paciente quirúrgico con cáncer del aparato digestivo. Cirujano General [México] 2001;23:290-5.

  55. Faintuch J, Cabraitz R, Martin-Nieto AR, Yagi OK, Zilberstein B, Cecconello I; et al. The prognostic value of colesterol values in malnourished patients with esophageal carcinoma. Nutrición Hospitalaria [España] 1993;8:352-7.

  56. Winawer SJ, Flehinger BJ, Buchalter J, Herbert E, Shike M. Declining serum cholesterol levels prior to diagnosis of colon cancer. A time-trend, case-control study. JAMA 1990;18:263:2083-5.

  57. Delgado Rodríguez M, Medina Cuadros M, Gómez Ortega A, Martínez Gallego G, Mariscal Ortiz M, Martínez González MA, Sillero Arenas M. Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Arch Surg 2002;137: 805-12.

  58. Palma S, Cosano A, Mariscal M, Martínez Gallego G, Medina Cuadros M, Delgado Rodríguez M. Cholesterol and serum albumin as risk factors for death in patients undergoing general surgery. Brit J Surg 2007;94:369-75.

  59. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil‐lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181-4.

  60. Delmore G. Assessment of nutritional status in cancer patients: Widely neglected? Support Care Cancer 1997; 5:376-80.

  61. Sungurtekin H, Sungurtekin U, Balci C, Zencir M, Erdem E. The influence of nutritional status on complications after major intraabdominal surgery. J Am Coll Nutr 2004;23:227-32.

  62. Valente da Silva HG, Santos SO, Silva NO, Ribeiro FD, Josua LL, Moreira ASB. Evaluación nutricional asociada con la estancia hospitalaria. Nutrición Hospitalaria [España] 2012;27:542-7.

  63. Leandro Merhi VA, de Aquino JLB, Chagas JFS. Nutrition status and risk factors associated with length of hospital stay for surgical patients. JPEN J Parenter Enteral Nutr 2011;35:241-8.

  64. Li D, Morris JS, Liu J, Hassan MM, Day RS, Bondy ML, Abbruzzese JL. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA 2009;301:2553-62.

  65. Bozzetti F, Migliavacca S, Scotti A, Bonalumi MG, Scarpa D, Baticci F; et al. Impact of cancer, type, site, stage and treatment on the nutritional status of patients. Ann Surg 1982;196:170-9.




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