Relation of Malnutrition and Nosocomical Infections in Cancer Patients in Hospital: An Observational Study

Bianca Tabita Muresan; Martín Núñez-Abad; Ana Artero; Jaime Rios Rios; Alberto Jacobo Cunquero-Tomás; Vega Iranzo; Javier Garrido; Ana Jiménez-Portilla; Carlos Camps Herrero; Carlos J Sánchez Juan

doi:10.1155/2022/5232480

Relation of Malnutrition and Nosocomical Infections in Cancer Patients in Hospital: An Observational Study

J Nutr Metab. 2022 Aug 16:2022:5232480. doi: 10.1155/2022/5232480. eCollection 2022.

Authors

Bianca Tabita Muresan^{1

2}, Martín Núñez-Abad³, Ana Artero^{1

4}, Jaime Rios Rios⁵, Alberto Jacobo Cunquero-Tomás^{2

3}, Vega Iranzo^{3

4

6}, Javier Garrido³, Ana Jiménez-Portilla^{1

2}, Carlos Camps Herrero^{6

7

8

9}, Carlos J Sánchez Juan^{1

6}

Affiliations

¹ Servicio de Endocrinología y Nutrición, Hospital General Universitario de Valencia, Valencia, Spain.
² Fundación Hospital General Universitario de Valencia, Valencia, Spain.
³ Servicio de Oncología Médica, Hospital General Universitario de Valencia, Valencia, Spain.
⁴ Departamento de Medicina, Universidad de Valencia, Valencia, Spain.
⁵ Servicio de Urgencias Hospitalarias, Hospital Clínico Universitario de Valencia, Valencia, Spain.
⁶ Centro de Investigación Biomédica en Red Cáncer CIBERONC, Madrid 28029, Spain.
⁷ Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.
⁸ Unidad Mixta TRIAL, Centro Investigación Príncipe Felipe-Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.
⁹ Department of Medicine, Universitat de València, Valencia, Spain.

Abstract

Aim: To investigate the relation between malnutrition and nosocomial infections (NI) in hospitalized cancer patients.

Methods: This observational, cross-sectional, noninterventional, descriptive study was conducted in a 500-bed university hospital in Valencia (Spain). Adult cancer patients admitted to the oncology ward were consecutively enrolled regardless of their nutritional status between November 2019 and March 2020. Patients were nutritionally assessed 24 to 48 hours after admission. Body weight, height and BMI, body composition through measurement of bioelectrical impedance analysis (BIA), and muscle strength and functionality using hand grip strength (HGS) were prospectively collected. The diagnosis of malnutrition and sarcopenia was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively. Patients were followed up during their hospital stay or outpatient oncology visits to identify possible NI.

Results: A total of 107 patients were included in this study (mean age 66 years; 66.4% were men). The most frequent reason for admission was cancer treatment (19.6%), followed by infections (18.7%) and digestive tract symptoms (18.7%). Overall, 77.5% (83/107) of the patients were malnourished at admission according to the GLIM criteria, while 52.3% (56/107) were sarcopenic. Nosocomial infections (NI) were significantly more frequent in malnourished (52.1%; 25/48) and severely malnourished (42.1%; 8/19) patients, compared with well-nourished patients without malnutrition (25%; 10/40; p=0.035). The mean length of hospital stay was 13.9 days, significantly longer in patients with an NI compared to those without infections (18.6 vs. 10.8 days, p < 0.024).

Conclusion: This study evidenced the need to implement a routine protocol for the nutritional assessment and support of cancer patients at risk of malnutrition and sarcopenia to reduce the risk of NI during their hospital stay.