Nutritional predictors of survival in terminally ill cancer patients

Sheng Yow Ho, How Ran Guo, Helen H.W. Chen, Cheau Jane Peng

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background and Purpose: Malnutrition can affect the prognosis of terminally ill patients, but over-treatment of malnutrition can worsen patient's quality of life. Decisions on nutrition and the supply of fluids to terminally ill patients are complex, and the identification of useful clinical indicators is needed. This study evaluated the relationships between various nutritional indices and survival of terminally ill cancer patients. Methods: We recruited terminally ill patients from a teaching hospital between February 2000 and January 2001. All of the 145 candidates were cancer patients, 109 (75%) of whom agreed to participate. Nutritional assessments including physical examination, anthropometric measurements, and biochemical profiles were performed on admission. Results: Univariate analyses showed that triceps skin-fold thickness (TSF) and midarm muscle circumference were significant predictors of survival. Poor survival was associated with prealbumin ≤ 100 mg/L (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.1 to 2.3; p = 0.03), asparate transaminase (AST) > 45 U/L (HR, 1.6; 95% CI, 1.1 to 2.3; p = 0.03), alkaline phosphate > 120 U/L (HR, 1.6; 95% CI, 1.1 to 2.5; p = 0.02), creatinine > 1.4 mg/dL (HR, 1.9; 95% CI, 1.2 to 3.2; p = 0.01), and blood urea nitrogen (BUN) > 20 mg/dL (HR, 1.9; 95% CI, 1.3 to 2.8; p < 0.01) at admission. Multivariate analyses found that-TSF < 25% of the nomogram (HR, 2.9; 95% CI, 1.6 to 5.3; p = 0.01), prealbumin ≤ 100 mg/L (HR, 2.2; 95% CI, 1.4 to 3.5; p < 0.01), AST > 45 U/L (HR, 2.0; 95% CI, 1.3 to 3.2; p = 0.01), and BUN > 20 mg/dL (HR, 2.8; 95% CI, 1.7 to 4.5; p < 0.01) were independent predictors of poor survival. Conclusions: This study found that nutritional status was associated with the survival of terminally ill cancer patients. Both TSF and prealbumin appeared to be useful predictors that may help set strategies to improve palliative care. Because predictors of survival are not necessarily factors that actually influence survival, further studies should be conducted to evaluate the usefulness of these prognostic indicators in clinical practice.

Original languageEnglish
Pages (from-to)544-550
Number of pages7
JournalJournal of the Formosan Medical Association
Volume102
Issue number8
Publication statusPublished - 2003 Aug 1

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Terminally Ill
Confidence Intervals
Survival
Neoplasms
Nutrition Assessment
Prealbumin
Blood Urea Nitrogen
Malnutrition
Skin
Transaminases
Nutritional Status
Palliative Care
Teaching Hospitals
Physical Examination
Creatinine
Phosphates
Quality of Life
Muscles

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{57a5f02298ac4cee99da53e892b64b22,
title = "Nutritional predictors of survival in terminally ill cancer patients",
abstract = "Background and Purpose: Malnutrition can affect the prognosis of terminally ill patients, but over-treatment of malnutrition can worsen patient's quality of life. Decisions on nutrition and the supply of fluids to terminally ill patients are complex, and the identification of useful clinical indicators is needed. This study evaluated the relationships between various nutritional indices and survival of terminally ill cancer patients. Methods: We recruited terminally ill patients from a teaching hospital between February 2000 and January 2001. All of the 145 candidates were cancer patients, 109 (75{\%}) of whom agreed to participate. Nutritional assessments including physical examination, anthropometric measurements, and biochemical profiles were performed on admission. Results: Univariate analyses showed that triceps skin-fold thickness (TSF) and midarm muscle circumference were significant predictors of survival. Poor survival was associated with prealbumin ≤ 100 mg/L (hazard ratio [HR], 1.5; 95{\%} confidence interval [CI], 1.1 to 2.3; p = 0.03), asparate transaminase (AST) > 45 U/L (HR, 1.6; 95{\%} CI, 1.1 to 2.3; p = 0.03), alkaline phosphate > 120 U/L (HR, 1.6; 95{\%} CI, 1.1 to 2.5; p = 0.02), creatinine > 1.4 mg/dL (HR, 1.9; 95{\%} CI, 1.2 to 3.2; p = 0.01), and blood urea nitrogen (BUN) > 20 mg/dL (HR, 1.9; 95{\%} CI, 1.3 to 2.8; p < 0.01) at admission. Multivariate analyses found that-TSF < 25{\%} of the nomogram (HR, 2.9; 95{\%} CI, 1.6 to 5.3; p = 0.01), prealbumin ≤ 100 mg/L (HR, 2.2; 95{\%} CI, 1.4 to 3.5; p < 0.01), AST > 45 U/L (HR, 2.0; 95{\%} CI, 1.3 to 3.2; p = 0.01), and BUN > 20 mg/dL (HR, 2.8; 95{\%} CI, 1.7 to 4.5; p < 0.01) were independent predictors of poor survival. Conclusions: This study found that nutritional status was associated with the survival of terminally ill cancer patients. Both TSF and prealbumin appeared to be useful predictors that may help set strategies to improve palliative care. Because predictors of survival are not necessarily factors that actually influence survival, further studies should be conducted to evaluate the usefulness of these prognostic indicators in clinical practice.",
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year = "2003",
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Nutritional predictors of survival in terminally ill cancer patients. / Ho, Sheng Yow; Guo, How Ran; Chen, Helen H.W.; Peng, Cheau Jane.

In: Journal of the Formosan Medical Association, Vol. 102, No. 8, 01.08.2003, p. 544-550.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nutritional predictors of survival in terminally ill cancer patients

AU - Ho, Sheng Yow

AU - Guo, How Ran

AU - Chen, Helen H.W.

AU - Peng, Cheau Jane

PY - 2003/8/1

Y1 - 2003/8/1

N2 - Background and Purpose: Malnutrition can affect the prognosis of terminally ill patients, but over-treatment of malnutrition can worsen patient's quality of life. Decisions on nutrition and the supply of fluids to terminally ill patients are complex, and the identification of useful clinical indicators is needed. This study evaluated the relationships between various nutritional indices and survival of terminally ill cancer patients. Methods: We recruited terminally ill patients from a teaching hospital between February 2000 and January 2001. All of the 145 candidates were cancer patients, 109 (75%) of whom agreed to participate. Nutritional assessments including physical examination, anthropometric measurements, and biochemical profiles were performed on admission. Results: Univariate analyses showed that triceps skin-fold thickness (TSF) and midarm muscle circumference were significant predictors of survival. Poor survival was associated with prealbumin ≤ 100 mg/L (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.1 to 2.3; p = 0.03), asparate transaminase (AST) > 45 U/L (HR, 1.6; 95% CI, 1.1 to 2.3; p = 0.03), alkaline phosphate > 120 U/L (HR, 1.6; 95% CI, 1.1 to 2.5; p = 0.02), creatinine > 1.4 mg/dL (HR, 1.9; 95% CI, 1.2 to 3.2; p = 0.01), and blood urea nitrogen (BUN) > 20 mg/dL (HR, 1.9; 95% CI, 1.3 to 2.8; p < 0.01) at admission. Multivariate analyses found that-TSF < 25% of the nomogram (HR, 2.9; 95% CI, 1.6 to 5.3; p = 0.01), prealbumin ≤ 100 mg/L (HR, 2.2; 95% CI, 1.4 to 3.5; p < 0.01), AST > 45 U/L (HR, 2.0; 95% CI, 1.3 to 3.2; p = 0.01), and BUN > 20 mg/dL (HR, 2.8; 95% CI, 1.7 to 4.5; p < 0.01) were independent predictors of poor survival. Conclusions: This study found that nutritional status was associated with the survival of terminally ill cancer patients. Both TSF and prealbumin appeared to be useful predictors that may help set strategies to improve palliative care. Because predictors of survival are not necessarily factors that actually influence survival, further studies should be conducted to evaluate the usefulness of these prognostic indicators in clinical practice.

AB - Background and Purpose: Malnutrition can affect the prognosis of terminally ill patients, but over-treatment of malnutrition can worsen patient's quality of life. Decisions on nutrition and the supply of fluids to terminally ill patients are complex, and the identification of useful clinical indicators is needed. This study evaluated the relationships between various nutritional indices and survival of terminally ill cancer patients. Methods: We recruited terminally ill patients from a teaching hospital between February 2000 and January 2001. All of the 145 candidates were cancer patients, 109 (75%) of whom agreed to participate. Nutritional assessments including physical examination, anthropometric measurements, and biochemical profiles were performed on admission. Results: Univariate analyses showed that triceps skin-fold thickness (TSF) and midarm muscle circumference were significant predictors of survival. Poor survival was associated with prealbumin ≤ 100 mg/L (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.1 to 2.3; p = 0.03), asparate transaminase (AST) > 45 U/L (HR, 1.6; 95% CI, 1.1 to 2.3; p = 0.03), alkaline phosphate > 120 U/L (HR, 1.6; 95% CI, 1.1 to 2.5; p = 0.02), creatinine > 1.4 mg/dL (HR, 1.9; 95% CI, 1.2 to 3.2; p = 0.01), and blood urea nitrogen (BUN) > 20 mg/dL (HR, 1.9; 95% CI, 1.3 to 2.8; p < 0.01) at admission. Multivariate analyses found that-TSF < 25% of the nomogram (HR, 2.9; 95% CI, 1.6 to 5.3; p = 0.01), prealbumin ≤ 100 mg/L (HR, 2.2; 95% CI, 1.4 to 3.5; p < 0.01), AST > 45 U/L (HR, 2.0; 95% CI, 1.3 to 3.2; p = 0.01), and BUN > 20 mg/dL (HR, 2.8; 95% CI, 1.7 to 4.5; p < 0.01) were independent predictors of poor survival. Conclusions: This study found that nutritional status was associated with the survival of terminally ill cancer patients. Both TSF and prealbumin appeared to be useful predictors that may help set strategies to improve palliative care. Because predictors of survival are not necessarily factors that actually influence survival, further studies should be conducted to evaluate the usefulness of these prognostic indicators in clinical practice.

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