Nutrition provided during the final weeks to patients with non-gastrointestinal solid malignancies

Tomoyuki Nonogaki; Keisuke Maeda; Akio Shimizu; Junko Ueshima; Ayano Nagano; Ryoko Kato; Yuria Ishida; Remi Yamanaka; Yosuke Yamanaka; Naoharu Mori

doi:10.1016/j.clnesp.2023.07.085

Nutrition provided during the final weeks to patients with non-gastrointestinal solid malignancies

Clin Nutr ESPEN. 2023 Oct:57:494-500. doi: 10.1016/j.clnesp.2023.07.085. Epub 2023 Jul 28.

Authors

Affiliations

¹ Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
² Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan. Electronic address: kskmaeda1701@gmail.com.
³ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Health Science, Faculty of Health and Human Development, The University of Nagano, 8-49-7, Nagano, Japan.
⁴ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa, Tokyo 141-8625, Japan.
⁵ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nursing Care, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo 663-821, Japan.
⁶ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
⁷ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Dentistry and Oral Surgery, Aichi Medical University 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
⁸ Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Japan.

PMID: 37739697
DOI: 10.1016/j.clnesp.2023.07.085

Abstract

Background & aims: Data regarding the delivery of nutrition and nutritional infusions to patients with terminal cancer remain limited; therefore, this real-world analysis investigated differences in nutrition delivery and infusion statuses for patients with terminal-stage cancers.

Methods: Patients who had died following hospitalization for more than seven days due to neoplasms between April 2014 and December 2018 were identified using the medical claims database of Japan. Data regarding oral diets, enteral feeding, infusion volumes, and infusion energies were extracted. The maximum observation period was 28 days prior to patient death.

Results: A total of 12,908 patients were included in our analysis. The proportion of patients without dietary or enteral nutrition increased closer to their dates of death. Observations were recorded at 28 (18.9%), 21 (20.9%), 14 (24.6%), 7 (33.0%), and 0 (80.2%) days prior to death. The infusion volumes given to the patients, as well as their energy contents, decreased near death (P-value for the trend <0.001).

Conclusions: Our study revealed the current status of nutritional therapy for patients with terminal cancer in Japan. The number of patients receiving only parenteral nutrition increased near death, while the amount of nutritional intake was low.

Keywords: Cancer; End of life; Enteral nutrition; Palliative care unit; Parenteral nutrition.

MeSH terms

Databases, Factual
Eating*
Enteral Nutrition
Hospitalization
Humans
Nutritional Status*