Predictors of survival in terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition

Nutrition. 2001 Jul-Aug;17(7-8):581-4. doi: 10.1016/s0899-9007(01)00579-2.

Abstract

Clinical, anthropometric, hematologic, and biochemical variables, evaluated immediately before starting nutritional treatment, were related to survival in 76 terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition. At baseline, abnormally low values were observed in the following percentages of patients: 40.8% for body mass index, 59.2% for serum albumin, 84.2% for hemoglobin, 48.7% for lymphocyte count, and 60% for serum cholesterol. Survival on home parenteral nutrition ranged between 6 and 301 d, with a median of 74 d. Hemoglobin, serum albumin and serum cholesterol were lower in patients with a survival of less than 3 mo. With regard to Karnofsky performance status, median survival times were 63 d for a score below or equal to 50 and 128 d for a score between 60 and 70. Albumin and a Karnofsky score above 50 (but not age, weight, body mass index, lymphocyte count, or cholesterol) emerged (with a positive sign) as predictors of survival. In conclusion, terminal-cancer patients with irreversible bowel obstruction are often malnourished, showing a high prevalence of anemia and hypoalbuminemia. Survival differs widely and can be predicted only to a limited extent from initial values of serum albumin and Karnofsky performance status.

MeSH terms

  • Body Mass Index
  • Cholesterol / blood
  • Female
  • Hemoglobins / analysis
  • Humans
  • Intestinal Obstruction / complications*
  • Intestinal Obstruction / therapy
  • Karnofsky Performance Status*
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / mortality
  • Neoplasms / therapy*
  • Parenteral Nutrition, Home*
  • Predictive Value of Tests
  • Serum Albumin / analysis
  • Survival Analysis
  • Terminal Care
  • Terminally Ill
  • Treatment Outcome

Substances

  • Hemoglobins
  • Serum Albumin
  • Cholesterol