Renata B Martucci1, Mariana V Barbosa2, Cristiane A D'Almeida3, Viviane D Rodrigues3, Anke Bergmann4, Nivaldo B de Pinho5, Luiz Claudio S Thuler6. 1. Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil; State University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: Renata.martucci@inca.gov.br. 2. Post Graduate in Medical Science, State University of Rio de Janeiro, Rio de Janeiro, Brazil. 3. Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil. 4. Carcinogenesis Molecular Program, Research Center, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil. 5. Technical Support Division, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil. 6. Clinical Research Division, Research Center, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil.
Abstract
OBJECTIVES: The aim of this study was to evaluate the 1-y survival of elderly patients with cancer and the association between undernutrition and mortality. METHODS: This was a cohort study with elderly patients ages ≥65 y admitted between September and October 2014. A nutritionist performed a Mini Nutritional Assessment-Short Form (MNA-SF) assessment during 48 h of hospital admission and collected data about potential confounding variables (comorbidities, stage of cancer, treatment in the previous 3 mo, and reason for hospitalization). Vital status was determined from the medical records or public records office. Overall survival was estimated using the Kaplan-Meier method. Cox regression was performed to estimate unadjusted hazard ratios. Variables with P < 0.20 by univariate analysis were selected for multivariate analysis. P < 0.05 was considered statistically significant. RESULTS: Of the 136 patients (mean age, 73.1 y; 52.2% men), 29.4%, 41.2%, and 29.4% were classified as normal, at risk for undernutrition, and undernutrition, respectively, according to the MNA-SF. The mortality rate was 31.6% after 12 mo. One-year mortality was higher among the undernourished patients, followed by patients at risk for undernutrition. After adjustment for confounding variables, the multivariate regression Cox model showed that being undernourished according to the MNA-SF increased the risk for death at 1 y (hazard ratio, 5.59; 95% confidence interval, 1.8-17.3; P < 0.001). CONCLUSION: The results showed that the MNA-SF can be a useful tool in identifying elderly patients at higher risk for 1-y mortality.
OBJECTIVES: The aim of this study was to evaluate the 1-y survival of elderly patients with cancer and the association between undernutrition and mortality. METHODS: This was a cohort study with elderly patients ages ≥65 y admitted between September and October 2014. A nutritionist performed a Mini Nutritional Assessment-Short Form (MNA-SF) assessment during 48 h of hospital admission and collected data about potential confounding variables (comorbidities, stage of cancer, treatment in the previous 3 mo, and reason for hospitalization). Vital status was determined from the medical records or public records office. Overall survival was estimated using the Kaplan-Meier method. Cox regression was performed to estimate unadjusted hazard ratios. Variables with P < 0.20 by univariate analysis were selected for multivariate analysis. P < 0.05 was considered statistically significant. RESULTS: Of the 136 patients (mean age, 73.1 y; 52.2% men), 29.4%, 41.2%, and 29.4% were classified as normal, at risk for undernutrition, and undernutrition, respectively, according to the MNA-SF. The mortality rate was 31.6% after 12 mo. One-year mortality was higher among the undernourished patients, followed by patients at risk for undernutrition. After adjustment for confounding variables, the multivariate regression Cox model showed that being undernourished according to the MNA-SF increased the risk for death at 1 y (hazard ratio, 5.59; 95% confidence interval, 1.8-17.3; P < 0.001). CONCLUSION: The results showed that the MNA-SF can be a useful tool in identifying elderly patients at higher risk for 1-y mortality.
Authors: Efrat Dotan; William P Tew; Supriya G Mohile; Huiyan Ma; Heeyoung Kim; Can-Lan Sun; Bette Caan; William Dale; Ajeet Gajra; Heidi D Klepin; Cynthia Owusu; Cary P Gross; Hyman Muss; Andrew Chapman; Vani Katheria; Arti Hurria Journal: Cancer Date: 2020-01-24 Impact factor: 6.860