Diagnosis of malnutrition according to glim criteria predicts complications and six-month survival in cancer outpatients.

Authors

null

Maria Marti Pi

Department of Medical Oncology, Hospital Clinico Lozano Blesa, Zaragoza, Spain

Maria Marti Pi , Marta Gascon Ruiz , Diego Casas-Deza , Irene Torres Ramon , Maria Zapata-Garcia , Andrea Sesma , Julio Jose Lambea- Sorrosal , Maria Alvarez , Elisa Quilez , Maria Zurera Berjaga , Alba Moratiel Pellitero , Ines Ruiz Moreno , Ana Goas Gomez , Dolores Isla , José Miguel Arbonés-Mainar

Organizations

Department of Medical Oncology, Hospital Clinico Lozano Blesa, Zaragoza, Spain, Gastroenterology department Hospital Miguel Servet Zaragoza, Zaragoza, Spain, Hospital Clinico Lozano Blesa, Zaragoza, Spain, Department of Medical Oncology, Clinico Lozano Blesa University Hospital, Zaragoza, Spain, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain, Medical Oncology, Hospital Clinico Lozano Blesa, Zaragoza, Spain, Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain, Hospital Clínico Lozano Blesa, Zaragoza, Spain, Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain

Research Funding

No funding received

Background: Malnutrition is a condition with great impact in oncology patients. Poor nutritional status is often associated with increased morbidity and mortality, increased toxicity and reduced tolerance to chemotherapy, among other complications. The recent GLIM criteria for malnutrition aim to homogenize its diagnosis, considering the baseline disease status. Due to the few studies that assess the predictive capacity of these new criteria, we aimed to evaluate their performance for the prediction of complications and mortality in patients with cancer. Methods: Prospective, single-centre study. All outpatients under active treatment for head and neck, upper gastrointestinal and colorectal tumors between February and October 2020 were recruited. These patients were followed up for 6 months, assessing the occurrence of complications and survival, based on GLIM diagnosis of malnutrition. Results: We enrolled 165 outpatients 46.66% malnutrition. During 6-month follow-up, patients with malnutrition (46.7%, according to GLIM criteria) had an ̃3-fold increased risk of hospital admission (p < 0.001) and the occurrence of severe infections (considered as such those requiring hospitalization, intravenous antibiotics and/or drainage by interventional procedure) during follow-up (p = 0.002). Similarly, malnourished patients had a 3.5-fold increased risk of poor pain control and a 4.4-fold increased need for a higher dose of opioids (both p < 0.001). They also had a 2.6-fold increased risk of toxicity (p = 0.044) and a 2.5-fold increased likelihood of needing a dose decrease or discontinuation of cancer treatment (p = 0.011). 6-month survival of malnourished patients was significantly lower (p = 0.023) than non-malnourished patients. Conclusions: Diagnosis of malnutrition according to GLIM criteria in oncology patients on active treatment predicts increased complications and worse survival at 6-month follow-up, making them a useful tool to assess the nutritional status of oncology patients.

Impact of malnutrition by GLIM criteria on follow-up.


No malnutritionN = 95
MalnutritionN = 70
OR
P
Emergency Room admission
42 (44.2%)
41 (58.6%)
1.78 [0.95;3.35]
0.071
Hospitalization
19 (20.0%)
35 (50.0%)
3.95 [2.00;8.01]
< 0.001
Severe infection
12 (12.6%)
23 (32.9%)
3.34 [1.54;7.57]
0.002
Poor pain control
26 (27.4%)
40 (57.1%)
3.50 [1.83;6.83]
< 0.001
Increase in opioid dosage
19 (20.0%)
37 (52.9%)
4.42 [2.24;8.99]
< 0.001
Toxicity
76 (80.0%)
64 (91.4%)
2.61 [1.03;7.65]
0.044
Decrease or discontinuation of treatment
60 (63.2%)
57 (81.4%)
2.53 [1.23;5.44]
0.011
Tumor Progression
29 (30.5%)
32 (45.7%)
1.91 [1.00;3.65]
0.049
6-month survival
83 (87.4%)
50 (71.4%)
0.37 [0.16;0.81]
0.012

OR: Odds ratio and 95% confidence intervals. p: p-value in logistic regression

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Palliative Care and Symptom Management

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e24093)

DOI

10.1200/JCO.2022.40.16_suppl.e24093

Abstract #

e24093

Abstract Disclosures

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