RESUMEN
RATIONALE: Quality of Life (QoL) is impaired in cancer, and the elderly are particularly vulnerable to malnutrition. A diagnosis of cancer in elderly patients further exacerbates risks of negative health outcomes. Here we investigated associations between QoL and nutritional status in a sample population of mostly socially deprived elderly cancer patients. METHOD: 432 cancer patients were recruited for this cross-sectional study at point of admission to a tertiary referral hospital for cancer treatment. Patient-generated subjective global assessment (PG-SGA) assessed nutritional status. Functional assessment of cancer therapy- general (FACT-G) quantified QoL. Relationship between PG-SGA and QoL was assessed by Spearman correlation. PG-SGA outcomes were compared against FACT-G scores employing Mann-Whitney test. Bivariate Linear Regression Model was employed to investigate influences of sociodemographic, clinical and nutritional status upon QoL. RESULTS: 37.5% of participants were malnourished or at risk. 39% were illiterate and 54.6% had family income lower than minimum wage. Malnourished patients showed lower FACT-G scores (76.8 vs. 84.7; p = 0.000). Poor nutritional diagnosis was inversely correlated with all QoL domains. Bivariate regression analysis showed that lower PG-SGA scores (ßo = - 1.00; p = 0.000) contributed to FACT-G score deterioration, the male gender showed better QoL scores, and other clinical and sociodemographic variables did not show relationship. CONCLUSION: Poorer nutritional status was significantly associated with worsened physical, social, emotional and functional well-being QoL domains in elderly cancer patients. Poorer nutritional status is an independent risk factor for worsened QoL. Future policies aimed at particularly vulnerable populations may improve QoL and health outcomes.
Asunto(s)
Desnutrición/psicología , Neoplasias/psicología , Estado Nutricional , Calidad de Vida , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Desnutrición/epidemiología , Desnutrición/etiología , Persona de Mediana Edad , Neoplasias/complicaciones , Evaluación Nutricional , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Introduction: The nutritional status and localization of the tumor are essential in the evaluation of the elderly with cancer, since they are related to morbimortality and have a direct impact on survival. Objective: To evaluate the nutritional status according to the mini nutritional assessment, body mass index and calf circumference, to identify the degree of agreement between these parameters and to verify the association between the nutritional status and the different types of cancer. Method: Cross-sectional study with elderly oncology patients admitted to a referral hospital in Salvador, Bahia. Data were collected using the mini nutrition assessment (reduced version), structured questionnaire for the collection of clinical data and sociodemographic profile, and anthropometric data. Descriptive analysis, chi-square test (x²) and Kappa test were performed. Results: It was observed that 41%, 54.3% and 74.3% of the patients presented adequate nutritional status according to the mini nutritional assessment, Body Mass Index and Calf Circumference, respectively, with moderate agreement (Kappa=0, 59) between Body Mass Index and mini nutritional assessment. The highest nutritional status was observed in patients diagnosed with head and neck cancer. Conclusion: In this study the mini nutritional assessment was more sensitive to identify inadequacy in the nutritional status when compared with the Body Mass Index and calf circumference; an association between nutritional status and tumor location was also observed. Probably, the subjective parameters of the mini nutritional assessment justify the diagnosis of earlier malnutrition, favoring nutritional intervention
Introdução: O estado nutricional e a localização do tumor são essenciais na avaliação do idoso com câncer, pois relacionam-se com morbimortalidade e impactam diretamente na sobrevida. Objetivo: Avaliar o estado nutricional segundo a mini avaliação nutricional, índice de massa corporal e circunferência da panturrilha, identificar o grau de concordância entre esses parâmetros e verificar a associação entre o estado nutricional e os diferentes tipos de câncer. Método: Estudo transversal, com pacientes idosos oncológicos internados em um hospital de referência em Salvador, Bahia. Na coleta dos dados, utilizou-se a mini avaliação nutricional (versão reduzida), questionário estruturado para coleta de dados clínicos e perfil sociodemográfico, e antropométricos. Realizaram-se análise descritiva, teste de qui--quadrado (x²) e teste Kappa. Resultados: Observou-se que 41%, 54,3% e 74,3% dos pacientes apresentavam estado nutricional adequado segundo a mini avaliação nutricional, índice de massa corporal e circunferência da panturrilha, respectivamente, com uma concordância moderada (Kappa=0,59) entre índice de massa corporal e mini avaliação nutricional. Os maiores comprometimentos do estado nutricional foram observados nos pacientes com diagnóstico de câncer de cabeça e pescoço. Conclusão: Neste estudo, a mini avaliação nutricional foi mais sensível para identificar inadequação no estado nutricional quando comparada com o índice de massa corporal e circunferência da panturrilha; observou-se ainda associação entre o estado nutricional e a localização do tumor. Provavelmente, os parâmetros subjetivos da mini avaliação nutricional justificam o diagnóstico de desnutrição mais precoce, favorecendo a intervenção nutricional.
Introducción: El estado nutricional y localización del tumor son esenciales en la evaluación del anciano con cáncer, pues se relacionan con morbimortalidad e impactan directamente en la supervivencia. Objetivo: Evaluar el estado nutricional según la mini evaluación nutricional, índice de masa corporal y circunferencia de la pantorrilla, identificar el grado de concordancia entre esos parámetros y verificar la asociación entre el estado nutricional y los diferentes tipos de cáncer. Método: Estudio transversal, con pacientes ancianos oncológicos internados en un hospital de referencia en Salvador, Bahia. En la recolección de los datos se utilizó la mini evaluación nutricional (versión reducida), cuestionario estructurado para recolección de datos clínicos y perfil sociodemográfico, y antropométricos. Se realizó análisis descriptivo, prueba de chi-cuadrado (x²) y prueba Kappa. Resultados: Se observó que 41%, 54,3% y 74,3% de los pacientes presentaban adecuado estado nutricional según la Mini Evaluación Nutricional, Índice de Masa Corporal y Circunferencia de la pantorrilla, respectivamente, con una concordancia moderada (Kappa=0, 59) entre índice de masa corporal y mini evaluación nutricional. Dado que los mayores compromisos del estado nutricional se observaron en los pacientes con diagnóstico de cáncer de cabeza y cuello. Conclusión: En este estudio la mini evaluación nutricional fue más sensible para identificar inadecuación en el estado nutricional cuando comparada con el Índice de Masa Corporal y Circunferencia de la pantorrilla; se observó una asociación entre el estado nutricional y la localización del tumor. Probablemente, los parámetros subjetivos de la mini evaluación nutricional justifican el diagnóstico de desnutrición más precoz, favoreciendo la intervención nutricional.