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Rev Bras Ter Intensiva. 2015 Jul-Sep;27(3):274-83. doi: 10.5935/0103-507X.20150032. Epub 2015 Aug 11.

Nutritional risk assessment in critically ill cancer patients: systematic review.

[Article in English, Portuguese]

Author information

1
Programa de Pós-Graduação em Medicina: Ciências Cirúrgicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR.
2
Unidade de Terapia Intensiva, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BR.
3
Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR.

Abstract

OBJECTIVE:

To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature.

METHODS:

The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words "nutritional risk assessment", "critically ill" and "cancer".

RESULTS:

Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values < 87 were significantly associated with mortality. A high Prognostic Inflammatory and Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found.

CONCLUSION:

None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic Score and Patient-Generated Subjective Global Assessment, is suggested given that their use is simple, feasible and useful in such cases.

PMID:
26270855
PMCID:
PMC4592123
DOI:
10.5935/0103-507X.20150032
[Indexed for MEDLINE]
Free PMC Article

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