The High Prevalence of Malnutrition in the Cancer Patients Admitted to Omid Hospital in Mashhad, Iran Based on the PG-SGA Questionnaire (2020)

Document Type : Research Paper

Authors

1 Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran

2 Health Education, Educational Supervisor of Omid Hospital, Mashhad University of Medical Sciences ,Mashhad, Iran

Abstract

Introduction: Cancer is a major health concern and the third leading cause of death in Iran. The prevention and management of malnutrition are recognized as the inherent elements of cancer care. The present study aimed to assess the prevalence of malnutrition and the influential factors in the cancer patients admitted to Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran in 2020. Methods: Malnutrition was detected using the patient generated-subjective global assessment (PG-SGA) in 113 cancer patients, who were selected from the Cancer Research Center of Omid Hospital. Data analysis was performed in SPSS version 16. Results: The PG-SGA scores indicated the moderate and severe prevalence of malnutrition in 3.6% and 96.4% of the cancer patients, respectively. No significant correlation was observed between the type of cancer and malnutrition due to the limited data of the patients receiving proper nutrition. However, significant correlations were denoted between the type of cancer, weight loss within the past six months, and education level of the patients (P<0.05). Xerostomia and anorexia were the most common dietary intake-related complaints in the cancer patients. Conclusion: According to the results, the prevalence of malnutrition was extremely high in the cancer patients receiving active treatment across all the treatment settings based on the PG-SGA scores. Furthermore, anorexia was the most common cause of decreased food intake by the patients. 

Keywords


1. Heery CR, Ibrahim NK, Arlen PM, Mohebtash M, Murray JL, Koenig K, et al. Docetaxel alone or in combination with a therapeutic cancer vaccine (PANVAC) in patients with metastatic breast cancer: a randomized clinical trial. JAMA oncology. 2015;1(8):1087-95.
2. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RG, Barzi A, et al. Colorectal cancer statistics, 2017. CA: a cancer journal for clinicians. 2017;67(3):177-93.
3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.
4. Valipour AA, Mohammadian M, Ghafari M, Mohammadian-Hafshejani A. Predict the future incidence and mortality of breast cancer in Iran from 2012-2035. Iranian journal of public health. 2017;46(4):579-80.
5. Ryan AM, Power DG, Daly L, Cushen SJ, Bhuachalla ĒN, Prado CM. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proceedings of the Nutrition Society. 2016;75(2):199-211.
6. D’Almeida CA PW, De Pinho NB, Martucci RB, Rodrigues VD, Ramalho A. Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter and Multiregional Study. The journal of nutrition, health & aging. 2020;1;24(2):166-71.
7. Chao P-C, Chuang H-J, Tsao L-Y, Chen P-Y, Hsu C-F, Lin H-C, et al. The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients. Biomedicine. 2015;5(3).
8. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai Setting and Association with Nutritional Parameters in Cancer Patients. Asian Pacific Journal of Cancer Prevention. 2019;20(4):1249-55.
9. e Melo Silva FR, de Oliveira MGOA, Souza ASR, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: a croos-sectional study. Nutrition journal. 2015;14(1):123.
10. F O. Patient generated subjective global assessment. In: McCallum P, Polisena C, editors. The clinical guide to oncology. Chicago IL. The American Dietetic Association. 2000;11-23.
11. Marshall KM, Loeliger J, Nolte L, Kelaart A, Kiss NK. Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points. Clinical nutrition. 2019;38(2):644-51.
12. Badosa EL, Tahull MB, Casas NV, Sangrador GE, Méndez CF, Meseguer IH, et al. Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay. Nutricion hospitalaria. 2017;34(4):907-13.
13. Thomas MN, Kufeldt J, Kisser U, Hornung H-M, Hoffmann J, Andraschko M, et al. Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system. Nutrition. 2016;32(2):249-54.
14. Ghoreishi Z, Shahabbasi J, Jager-Wittenaar H, Ottery F, Jafarabadi MA, Dolatkhah R, et al. MON-PO538: Cross Cultural Adaptation and Validation of the ‘Patient-Generated Subjective Global Assessment (PG-SGA)’for Nutritional Status Assessment of Cancer Patients in Iran. Clinical Nutrition. 2019;38:S258.
15. 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. European journal of clinical nutrition. 2002;56(8):779.
16. Sarvarian R, Khoshnevis N, Amiri Z, Haghighian Roudsari A, Rashidi A. Prevalence of malnutrition and its relationship to socio-economic variables for cancer patients admitted to Shohada-ye-Tajrish hospital in 2010. Nutr Sci Food Technol. 2013;8(3):261-7.
17. Movahed S, Neda Mousavi S, Mozaffari V, Makhdoumi Y, Zeraati A, Firuzabadi P, et al. Evaluation of nutritional status of patients with malignancy in an outpatient radiation oncology clinic in Mashhad. Med J Mashhad Univ Med Sci. 2015;58(1):49-55.
18. Gholami SS, Ardekani TM, Karami K, Taheri A, Gholamnezhad M. Evaluation of malnutrition status in patients admitted to Shahid Rajaee hospital in Gachsaran City in 2016. Middle East Journal of Family Medicine. 2017;7(10):150.
19. Movahedi M, Haghighat S, Khayamzadeh M, Moradi A, Ghanbari-Motlagh A, Mirzaei H, et al. Survival rate of breast cancer based on geographical variation in Iran, a national study. Iran Red Crescent Med J. 2012;14(12):798.
20. Zarif Yeganeh M, Eghtesadi S, Vakili M, Faghih A, Haghani H, Noormohammadi I, et al. Nutritional assessment of cancer patients during chemotherapy in Iran University of medical sciences affiliated hospitals, 2006-2007. Razi j Med Sci. 2009;16:0-.
21. Kabir M, Keshtkar A, Lashkar BF. Prevalence of malnutrition in children under 2 years old and its relationship with mothers background variables in Golestan province. 2006.
22. KIMIAGAR SM, Bazhan M. Poverty and malnutrition in Iran. 2005.
23. Pirlich M, Schütz T, Kemps M, Luhman N, Minko N, Lübke HJ, et al. Social risk factors for hospital malnutrition. Nutrition. 2005;21(3):295-300.
24. Read JA, Choy SB, Beale P, Clarke SJ. An evaluation of the prevalence of malnutrition in cancer patients attending the outpatient oncology clinic. Asia‐Pacific Journal of Clinical Oncology. 2006;2(2):80-6.
25. Naber TH, Schermer T, de Bree A, Nusteling K, Eggink L, Kruimel JW, et al. Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications. The American journal of clinical nutrition. 1997;66(5):1232-9.