Clinical malnutrition predictive model among gynecologic cancer patients prior to elective operation: A cross-sectional study

Chiou Yi Ho; Zuriati Ibrahim; Zalina Abu Zaid; Zulfitri 'Azuan Mat Daud; Nor Baizura Md Yusop

doi:10.1016/j.clnu.2021.01.008

Clinical malnutrition predictive model among gynecologic cancer patients prior to elective operation: A cross-sectional study

Clin Nutr. 2021 Jun;40(6):4373-4379. doi: 10.1016/j.clnu.2021.01.008. Epub 2021 Jan 12.

Authors

Chiou Yi Ho¹, Zuriati Ibrahim², Zalina Abu Zaid³, Zulfitri 'Azuan Mat Daud³, Nor Baizura Md Yusop³

Affiliations

¹ Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia; Dietetics and Food Service Department, National Cancer Institute, 4, Jalan P7, Presint 7, 62250, Putrajaya, Ministry of Health, Malaysia.
² Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia. Electronic address: zuriatiib@upm.edu.my.
³ Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia.

PMID: 33485706
DOI: 10.1016/j.clnu.2021.01.008

Abstract

Background: Malnutrition is common among cancer patients regardless of stage of cancer. Given the strong association between malnutrition with prolonged hospitalization, delayed recovery and even higher post-operative complications among gynaecologic cancer (GC) patients, it is important to understand its predictive factors. The current study aimed to determine malnutrition predictors among GC patients before elective operation.

Method: A cross-sectional study was conducted among surgical GC patients who were admitted for elective surgery. Data on socio-demographic characteristics, clinical status (diagnosis, the staging of cancer, comorbidities and family history on cancer), anthropometric measures [ Body Mass Index (BMI), weight changes, the percentage of weight loss past one month, muscle mass, fat mass, fat-free mass and mid-upper arm circumference (MUAC)], biochemical profiles [C-reactive protein, albumin and C-reactive protein (CRP) to albumin ratio (CAR)], handgrip strength, total daily energy and protein intake, and malnutrition status [scored Patient Generated-Subjective Global Assessment (PG-SGA)] were assessed during admission.

Results: Study recruited 124 participants and 57.2% (n = 71) were malnourished. Mean for age, weight changes past one month, handgrip strength, total daily energy and protein intake, PG-SGA score and CAR of participants were 49.9 ± 12.5 years, -4.9 ± 7.2%, 15.6 ± 6.2 kg, 25±7 kcal/kg/day, 1.0 ± 0.3 g/kg/day, 6.5 ± 5.4 and 0.7 ± 1.9, respectively. Multiple linear regression test revealed that the percentage of weight loss past one month, haemoglobin, CRP and handgrip strength were the significant predictors of malnutrition.

Conclusion: Malnutrition is common among GC patient even before elective operation. The early malnutrition screening following with proper nutritional intervention is crucial to optimize nutritional status among GC patients before elective operation.

Keywords: Elective operation; Gynaecologic cancer; Malnutrition; Predictive.

MeSH terms

Adult
Aged
Aged, 80 and over
C-Reactive Protein / analysis
Cross-Sectional Studies
Elective Surgical Procedures*
Female
Genital Neoplasms, Female / complications*
Genital Neoplasms, Female / surgery*
Hand Strength
Hemoglobins / analysis
Humans
Malnutrition / complications*
Malnutrition / diagnosis*
Middle Aged
Nutritional Status*
Preoperative Period
Weight Loss
Young Adult

Substances

Hemoglobins
C-Reactive Protein