Malnutrition Risk Is Associated With All-Cause Mortality and Chemotherapy Complications Among Adults Diagnosed With Diverse Cancer Types: A Retrospective Cohort Study.
Rachel Hoobler, Manuela Herrera, Kary Woodruff, Alejandro Sanchez, Adriana M Coletta, Amandine Chaix, Joan Elizondo, Mary C Playdon
{"title":"Malnutrition Risk Is Associated With All-Cause Mortality and Chemotherapy Complications Among Adults Diagnosed With Diverse Cancer Types: A Retrospective Cohort Study.","authors":"Rachel Hoobler, Manuela Herrera, Kary Woodruff, Alejandro Sanchez, Adriana M Coletta, Amandine Chaix, Joan Elizondo, Mary C Playdon","doi":"10.1016/j.jand.2025.04.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Studies investigating the association of malnutrition with mortality and complications of cancer treatment in oncology patients are primarily restricted to head and neck and gastrointestinal cancers. Yet, malnutrition risk factors are experienced across cancer types.</p><p><strong>Objective: </strong>To evaluate the association of malnutrition risk, assessed by the Malnutrition Screening Tool, with all-cause mortality and complications of chemotherapy and radiation among oncology patients.</p><p><strong>Design: </strong>A retrospective cohort study using electronic medical record data from January 2021 to April 2024.</p><p><strong>Participants/setting: </strong>Two thousand eight hundred fifty-nine adult cancer patients with a Malnutrition Screening Tool score within 1 year of a cancer diagnosis were included. Patients were treated at 9 outpatient clinics in the western United States.</p><p><strong>Main outcome measures: </strong>The primary outcome was all-cause mortality. Secondary outcomes were complications of chemotherapy and radiation.</p><p><strong>Statistical analysis performed: </strong>Cox proportional hazards regression, adjusted for key confounders, was used to evaluate the association of malnutrition risk with time to death from any cause. A secondary analysis stratified by cancer type was conducted when sample size permitted. Multivariable logistic regression was used to assess the association of malnutrition risk with the first treatment-related complication.</p><p><strong>Results: </strong>Malnutrition risk, compared with no risk, was significantly associated with increased risk for all-cause mortality for all cancer patients combined (hazard ratio 1.70; 95% CI, 1.39-2.07; P < .001) and some specific cancer types, such as lung cancer (hazard ratio 1.58; 95% CI, 1.05 to 2.37; P = .03). Malnutrition risk was also associated with increased likelihood of complications of chemotherapy in all cancers combined (odds ratio 1.49; 95% CI, 1.11-2.00; P < .01).</p><p><strong>Conclusions: </strong>Malnutrition risk was associated with elevated risk of mortality and chemotherapy complications for all cancers combined. These results highlight the importance of malnutrition risk in cancer prognosis.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Academy of Nutrition and Dietetics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jand.2025.04.014","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Studies investigating the association of malnutrition with mortality and complications of cancer treatment in oncology patients are primarily restricted to head and neck and gastrointestinal cancers. Yet, malnutrition risk factors are experienced across cancer types.
Objective: To evaluate the association of malnutrition risk, assessed by the Malnutrition Screening Tool, with all-cause mortality and complications of chemotherapy and radiation among oncology patients.
Design: A retrospective cohort study using electronic medical record data from January 2021 to April 2024.
Participants/setting: Two thousand eight hundred fifty-nine adult cancer patients with a Malnutrition Screening Tool score within 1 year of a cancer diagnosis were included. Patients were treated at 9 outpatient clinics in the western United States.
Main outcome measures: The primary outcome was all-cause mortality. Secondary outcomes were complications of chemotherapy and radiation.
Statistical analysis performed: Cox proportional hazards regression, adjusted for key confounders, was used to evaluate the association of malnutrition risk with time to death from any cause. A secondary analysis stratified by cancer type was conducted when sample size permitted. Multivariable logistic regression was used to assess the association of malnutrition risk with the first treatment-related complication.
Results: Malnutrition risk, compared with no risk, was significantly associated with increased risk for all-cause mortality for all cancer patients combined (hazard ratio 1.70; 95% CI, 1.39-2.07; P < .001) and some specific cancer types, such as lung cancer (hazard ratio 1.58; 95% CI, 1.05 to 2.37; P = .03). Malnutrition risk was also associated with increased likelihood of complications of chemotherapy in all cancers combined (odds ratio 1.49; 95% CI, 1.11-2.00; P < .01).
Conclusions: Malnutrition risk was associated with elevated risk of mortality and chemotherapy complications for all cancers combined. These results highlight the importance of malnutrition risk in cancer prognosis.
背景：调查肿瘤患者营养不良与死亡率和癌症治疗并发症之间关系的研究主要局限于头颈部和胃肠道癌症。然而，营养不良的风险因素在各种癌症类型中都存在。目的：评价营养不良筛查工具（MST）评估的肿瘤患者营养不良风险与全因死亡率及化疗和放疗并发症的关系。设计：一项回顾性队列研究，使用2021年1月至2024年4月的电子病历数据。参与者/设置：包括2,859名成年癌症患者，他们在癌症诊断的一年内有MST评分。患者在美国西部的9家门诊诊所接受治疗。主要结局指标：主要结局指标为全因死亡率。次要结局是化疗和放疗的并发症。进行统计分析：采用Cox比例风险回归，对关键混杂因素进行调整，评估营养不良风险与任何原因导致的死亡时间之间的关系。在样本量允许的情况下，进行了按癌症类型分层的二次分析。采用多变量logistic回归评估营养不良风险与首次治疗相关并发症的关系。结果：与无风险相比，营养不良风险与所有癌症患者全因死亡风险增加显著相关（HR 1.70, 95% CI 1.39-2.07, p < 0.001）和某些特定癌症类型，如肺癌（HR 1.58, 95% CI 1.05-2.37, p = 0.03）。营养不良风险也与所有癌症合并化疗并发症的可能性增加相关（OR 1.49, 95% CI 1.11-2.00, p < 0.01）。结论：营养不良风险与所有癌症合并的死亡率和化疗并发症风险升高有关。这些结果强调了营养不良风险在癌症预后中的重要性。
期刊介绍：
The Journal of the Academy of Nutrition and Dietetics is the premier source for the practice and science of food, nutrition, and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, foodservice systems, leadership and management, and dietetics education.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
