Starving for attention: Malnutrition screening in a community cancer center.

Abstract

96 Background: It is estimated that 50% of cancer patients are at risk for malnutrition, causing physical and emotional distress that interferes with cancer treatment. Early detection and intervention may prevent severe malnutrition. Assessment and management of malnutrition are included in National Comprehensive Cancer Network (NCCN) guidelines but no specific recommendation regarding screening tool selection is provided. The Malnutrition Screening Tool (MST) is a short, easily administered screening tool, validated for identification of malnutrition in cancer patients. In this study, we describe the results of MST administration in a large community cancer institute. Methods: The MST was administered during all patient visits to our cancer institute in 2015. Patients scoring 2 or higher were identified as ‘at risk’ for malnutrition, resulting in electronic dietitian referral prompts. We retrospectively reviewed MST results from April through June 2015 and compared to dietitian referrals during the same period in 2014. At that time, dietitian consults were prompted by physician referral, patient request, or triggered by NCCN distress thermometer screen. Results: The MST identified 84% more patients in need of dietitian referral in 2015 compared to usual care in 2014. From April through June 2015, the MST was administered during 4082 discrete patient encounters. 6.7% of these visits resulted in MST score of 2 or greater for a total of 193 ‘at risk’ patients in need of referral to dietitian. Weight loss of 2 pounds or greater was reported by patients in 16% of encounters. Eating poorly because of a decreased appetite was reported by patients in 13% of the encounters. From April through June 2014, 105 patients were referred for dietitian consult, indicating the MST identified 88 more ‘at risk’ patients. Conclusions: The MST is a simple, valid tool for malnutrition screening in cancer patients that resulted in an 84% increase in identification of ‘at risk’ patients. This tool should be considered for standard malnutrition screening of cancer patients, to prompt referral for dietitian intervention.