The incidence of cancer is gradually increasing in China and is the leading cause of death, producing a heavy disease burden . Cancer patients are more likely to suffer from malnutrition due to anti-tumor therapy and high energy consumption. Malnutrition is responsible for the death of almost 20% of cancer patients and is mainly caused by insufficient protein intake, which has a significant adverse effect on the daily living, survival time, and treatment success of cancer patients.
The present study analyzed 339 elderly hospitalized patients and revealed that only 40.8% of cancer patients were well nourished and 25.9% (21/81) needed improvement in nutritional status or urgent nutritional support, indicating that elderly patients with cancer are more prone to malnutrition and nutritional support should be provided in a timely manner according to the general situation of the patient.
Interestingly, our research shows that in comparison with the non-cancer group, patients in the cancer group were younger with lower rates of polypharmacy and swallow dysfunction and an increased ADL score, which may be due to the age factor. As expected, cancer patients had higher rates of inflammation, a decreased MNA-SF score, and markedly decreased levels of BMI, TP, PA, Hb, and TLC. Our results are similar to previous findings by Alifano et al. showing that nutrition and systemic inflammation are prognostic determinants in lung cancer patients. Moreover, Extermann et al. found that comprehensive geriatric assessment can predict mortality and morbidity in elderly patients with cancer.
We also found that the MNA-SF score had a positive correlation with BMI, TP, ALB, PA, Hb, TLC, and ADL score, but a negative correlation with CRP levels, WST score, polypharmacy rate, and age. Previous studies have also shown that the MNA-SF can be an independent predictor and useful tool in identifying elderly cancer patients at a higher risk of early mortality[9, 10].
Overall, malnutrition is an important factor in the prognosis and death of cancer patients. Geriatric professionals should pay more attention to the nutritional status of cancer patients and identify the relevant factors of malnutrition, such as age, gender, BMI, NBP, and NRS, in a timely and accurate manner to provide patients with effective nutritional support, improve nutritional status and quality of life, and extend survival time.
There are several limitations of the present research. Firstly, retrospective chart analysis cannot establish causality conclusions. In addition, patients were from one medical center rather than multiple centers; thus, our research should be generalized with caution. Further research should be conducted to verify the results in a larger sample of well-represented patients from primary care using a longitudinal design. These results may not be representative of patients outside the Shenyang region in China.