| Objective:To investigate the nutritional status of inpatients with malignant tumor in Chongqing GeneralHospital.We investigate the nutritional risk,nutritional status,physical status,quality of life of hospitalized cancer patients.We also investigate the nutritional support and 30 days dead of these patients in this hospitalized duration.We analysis the relationship between demographic characteristics and nutritional status.We also analysis the relationship between nutritional status and recent clinical outcomes.and patient,and and and the relationship between clinical verification and comparative analysis of PG-SGA score and body measurement,relationship between the laboratory indexes.,and to analyze the influence of nutritional status,functional status and quality of life on the clinical outcomes.Methods:This is a cross-sectional study,single center,continuous sampling design.We contin uousenrolled 531 patients with cancer hospitalizedfor cancer treatmentin Chongqing General Hospital from May 4,2015 to June 30,2016 into this study.ThesePatients were diagnosed with one of the following 18 different types of malignant tumors: lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain tumor,biliary tract malignant tumors and gastric stromal tumors.Their nutritional risk was screened using Nutritional Risk Screening 2002(NRS-2002).Their individual nutritional status was evaluated using the Patient Generated-Subjective Global Assessment(PG-SGA)questionnaire.Their quality of life was measured using the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30.Physical status was assessed byscores of Karnofsky Performance Status(KPS).Results:1.Among the 531 inpatients,the average PG-SGA score of all the patients was7.26±6.24.57.25% of the patients were moderately and severely malnourished(PG-SGA scores?4),in which,36.35%(193)were severely malnourished(scores?9);20.90%(111)of the patients were moderatelymalnourished(scores 4-8),24.86%(132)were suspected to be malnourished(scores 2-3),and only 17.89%(95)were well-nourished(scores 0-1).2.The incidence of malnutrition was associated with different tumor types(x2=132.947,P<0.001).The highest average PG-SGA score(16.70±6.31)was seen inpancrestic cancer patients.The incidence of malnutrition in pancreatic cancer patients was the highest,up to 100%,followed by patients with malignant tumor of biliary tract,the incidence of malnutrition was 84.61%,the lowest average PG-SGA score(3.60±3.63)was seen in breast cancer patients,and therelatively good nutritional status In patients with breast cancer,the incidence of malnutrition was 16.66%.The patientswith the severely malnourish scores(score?9)were those with cancers of pancreas(60.1%),biliary tract(56.1%),esophagus(46.7%)and stomach(41.3%).All patients were divided into gastrointestinal tumor patients and non-gastrointestinal tumor patients.,digestive tract cancer patients found nutrition malnutrition rates were significantly higher than that in non gastrointestinal tumors(69.82% vs 48.22%),the difference was statistically significant(x2=24.627,P<0.001);PG-SGA quantitative score is the highest score of pancreas cancer,a score of 16.70 ±6.31;followed by esophageal cancer,a score of 11.74 ± 6.80;the lowest score is breast cancer,2.78 ±3.36;3.eat if there are problems,there is no appetite,have nausea,vomiting If there is vomiting,constipation,diarrhea,feel the food did not taste,whether there is difficulty in swallowing,whether there is a feeling of satiety and whether there is pain can affect the nutritionalstatus of patients(x2 = 285.006?199.783?37.450?24.364?11.526?5.297?7.948?20.414?58.234?24.583,P< 0.05);and the nutritional status and oral ulcer,there was no significant difference of food smells good(P = 0.221?0.083,respectively);4.single factor analysis of gender,age,Marital status,education level,whether drinking,treated and affect the nutritional status of patients with pathological staging(x2 = 10.685?26.456 ? 10.740 ? 16.239 ? 4.513 ? 23.382 ? 64.793,P<0.05);living location,expense reimbursement,smoking,or drinking tea,if there is no effect on the nutritional status of chronic disease(P = 0.072?0.462?0.071?0.910?0.700,respectively)two classification Logistic regression analysis;PG-SGA score And gender,age,whether the digestive tract tumor,whether received treatment,pathological staging,regression coefficient B = 0.507?0.845?0.795?-0.871?1.588(P<0.05),OR = 1.660?2.238?2.215?0.418?4.893,the biggest impact on the nutritional status of patients with the disease is the pathological staging;5.multiple linear regression analysis of PG-SGA score and laboratory indexes the relationship between body mass index,and weight 1 months ago,within 1 months the percentage of weight loss,BMI,non dominant hand grip,The maximum diameter of the left leg,ALB,PA and HB regression coefficient B = 0.473?0.687?-0249?-0.174?-0.331?-0.326?-0.048?-0.022(P<0.05),the best correlation is the percentage of weight loss within 1 months;and MAC,AMC,TSF,TLC and PG-SGA were not related with each other(P = 0.782?0.546?0.430?0.447respectively),6.NRS-2002 score more than 3 points in 232 cases,accounting for 43 of the total number of cases.69%;the incidence of nutritional risk associated with different tumor types(x2=70.169,P<0.001),the nutritional risk is the largest of the 68.42% leukemia patients,followed by the patients with digestive tract cancer 62.93%,breast cancer patients with nutritional risk minimum 8.33%;nutritional risk and gender related(x2=4.546,P =0.033),the number of male patients nutritional risk than women(47.27% vs 37.81%);nutritional risk and age related(x2=28.918,P<0.001)Nutritional risk in patients with age more than 65 years old is higher than that of aged <65 patients(56.49% vs 33.22%);the PG-SGA score of patients with cancer as a nutritional assessment criteria,NRS-2002 sensitivity,specificity,positive predictive value and negative predictive value were 0.717?0.938?0.940?0.712;and the consistency of the detection and evaluation of PG-SGA,the difference was statistically significant(Kappa=0.630,P<0.001);7.Karnofsky score in 229 patients with 80-100 patients,the total number of cases of 43.13%,50-70 in 259 cases(48.78%),0-40 43 cases(8.09%);Karnofsky score and tumor related categories(x2=105.980,P<0.001)function is the best state(80-100 points)of breast cancer patients(83.33%),the worst is the leukemia patients(15.79%);Karnofsky score correlated with nutritional status,with statistical significance the mean values of the difference between the groups(F=123.217,P<0.001);Karnofsky score and patients admitted to hospital within 30 days of death related to the outcome(x2=200.068,P <0.001);8.the quality of life of patients with tumor total score and nutritional status,between the two groups was statistically significant difference between the mean values(F=219.145,P<0.001);all the items and the quality of life in patients with PG-SGA tumors have correlation(P<0.05);total quality of life score and patients in the hospital within 30 days of death related to the outcome(x2=31.157,P<0.001);total quality of life score and KPS score(x2=204.619,P<0.001);9.moderate to severe malnutrition in patients with nutritional support rate was only 38.16 %(116/304),accounting for the nutritional support in patients with 91.38% separate parenteral nutrition(106/116),enteral nutrition combined with parenteral nutrition in malnourished patients accounted for 2.63%(8/304),enteral nutrition alone only in 2 cases,accounting for 0.66% of the patients with malnutrition(2/304);10.all of thisadmission within 30 days after the death of 23 cases(4.33%),508 cases survived(95.67%),death in patients with nutritional status(x2=42.429,P<0.001);the average hospitalization time 20.24 ±17.736 days,1-115 days,days of hospitalization between the nutritional status and the difference was not statistically significant(P =0.280);the total hospitalization expenses mean 31739.38 ±34232.964 yuan(1383-360107),associated with the nutritional status between the groups,the mean values of the difference was statistically significant(F =5.716,P =0.001).Conclusion:1.57.25% the common malignant tumor in patients have different degrees of malnutrition,PG-SGA as nutritional assessment tools,simple and effective.2.directly related with the clinical symptoms.3.43.69% patients is the process of eating nutritional risk,NRS-2002 can be used for screening of nutritional risk in patients with malignant tumor.4.gender,age,or upper gastrointestinal tumor whether they had received treatment and pathological stage affect the nutritional status of patients,the greatest impact is the disease of patients with pathological staging,clinical nutrition in patients with advanced cancer attaches great importance to the issue of.5.BMI,the last 1 months of weight The percentage of non profit decline,hand grip strength,the maximum diameter of the left leg,ALB,PA,HB associated with nutritional status,the best correlation is the last 1 months,weight loss percentage of.6.the quality of life of nutrition influences the functional status,patients,the total hospitalization expenses and the prognosis of.7.the KPS score is a reliable and the effective evaluation of the functional status of patients with cancer,and can predict the prognosis of.8.the quality of life of patients with cancer and nutritional status,functional status,and can predict the prognosis of patients with cancer.9.patients with cancer,malignant tumor patients with malnutrition nutritional support rate is very low,especially enteral nutrition.Nutritional risk screening recommendations and low rate of admission of patients with malignant tumor after the PG-SGA score,and include Provide a comprehensive nutritional assessment and give proper nutrition support. |
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