Diagnostic work-up for the detection of malnutrition in hospitalized cancer patients

Malnutrition is a common complication in patients suffering from cancer. It is associated with a poor prognosis, reduced quality of life, increased chemotherapy-induced toxicity, and a decreased response to therapy.

To evaluate and compare the use of various diagnostic tests for the detection of malnutrition in patients hospitalized for cancer treatment.

In this single-center, non-interventional reliability study, the nutritional status of 50 patients with cancer was assessed using the Nutritional Risk Screening (NRS-2002), a bioimpedance analysis (BIA), and the measurement of laboratory parameters that reflect the serum visceral protein level. For statistical analysis, the comparison of means and the agreement of the methods were calculated.

NRS-2002, BIA, and lab parameters differed widely among patients classified as well-nourished or malnourished (10%- 80%, depending on the method). Significant results in the comparison of means were observed for body mass index, serum protein, and some BIA parameters. The analysis of agreement identified a compelling agreement for pre-albumin and retinol-binding protein (RBP) (kappa = 0.81).

Small sample size, heterogeneous group of patients, non-interventional reliability study.

The tested diagnostic methods for detecting malnutrition did not have an evident agreement among each other with a limited exchangeability. In routine hospital practice several methods should be applied in order to identify cancer patients at risk of malnutrition.