Abstract
Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ± 8.2. By the end of the chemotherapy, the mean weight gain was 0% ± 7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.
Highlights
Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality
Of the initial 295 patients included in the study when the nutritional care model was initiated for cancer patients, 51 (17%) did not complete chemotherapy
The nutrition consultation showed that 84 patients required individualised nutritional care: 27 (32.1%) belonged to group 1, and another 12 had Nutriscore ≥ 5 at the start of treatment, and 45 patients, not at nutritional risk at the start of treatment, had recorded weight loss (WL) during one or more of the periodic re-evaluations, on day 1 of each cycle of chemotherapy
Summary
Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ± 8.2. Oncological care is evolving to become a multidisciplinary model incorporating a wide range of services and c oncerns[2] Within this broader approach, weight loss (WL) and other signs of deteriorating nutritional status require special attention, due to their impact and prevalence, and so action protocols should be established to promote comprehensive nutritional care[2]. The latest recommendations on nutritional care for cancer patients emphasise the importance of detection and prompt action for persons at nutritional risk, to prevent the onset of malnutrition and to minimise its devastating effect on the patient’s clinical condition[3]
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