Thiamine deficiency in cancer patients at initial admission to a palliative care unit: a single-centre...

Thiamine deficiency (TD) has been increasingly reported among patients undergoing active cancer treatment. However, its status in end-of-life cancer patients admitted to palliative care units remains unclear. This study aimed to determine the prevalence of TD and associated factors in end-of-life cancer patients on initial admission to a palliative care unit.

This single-centre descriptive cross-sectional study included end-of-life cancer patients admitted for the first time to a palliative care unit between 1 January 2020 and 31 December 2023. Whole blood thiamine concentrations measured on admission were analysed using high-performance liquid chromatography. The TD group was defined as <24.0 ng/mL and the thiamine normal group as 24.0-66.0 ng/mL. Patient characteristics were summarised using descriptive statistics, and factors associated with TD were examined using multivariable logistic regression, adjusting for age and clinical background variables.

TD was identified in 85 (36%) of 234 patients. Multivariable logistic regression showed that only a serum albumin level <3.0 g/dL was significantly associated with TD (adjusted OR 2.05, 95% CI 1.10 to 3.90; p=0.023). Age, body mass index, Eastern Cooperative Oncology Group performance status, a history of chemotherapy within 1 month prior to admission and gastrointestinal malignancy were not significantly associated with TD.

TD was identified in 36% of end-of-life cancer patients and found to be associated with serum albumin level. In end-of-life cancer patients, particularly those with low serum albumin levels, clinicians should be mindful of the possibility of TD.