CN40 - Nutritional risk screening (NRS 2002), Prognostic nutritional index (PNI) and Controlling nutritional status (CONUT) in patients with digestive cancer: An observational study

Background

From 45-80% of cancer patients report a state of malnutrition resulting in reduced efficacy of cancer therapies and worse prognosis. It is estimated that more than 40% of patients die due to malnutrition rather than cancer itself. Patients with cancer of the digestive tract suffer from a more severe state of malnutrition than patients with cancers of other nature. Nurses are recommend to conduct nutritional screening using validated tools such as Nutritional Risk Screening 2002 (NRS 2002). Indices such as Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) are also useful. This study aims to describe the risk of malnutrition using the three scoring systems and to evaluate whether these screening tools can highlight a difference in patients with digestive tract cancer.

Methods

A retrospective descriptive study: N. 322 medical records of patients discharged, from 01/2022 to 03/2024, on the compiled scale of NRS-2002 were analysed. PNI and CONUT of patients referred to the Abdominal Oncology of IRCCS G. Pascale were analysed. According to the literature, patients were divided into 2 groups: patients with upper digestive tract cancer (Group1: pancreas, stomach, cardia, oesophagus, gastroesophageal junction) with a higher risk of malnutrition compared to those with lower digestive tract cancer (Group2: colon, rectum, sigmoid, bile duct and liver).

Results

From the analysis of the NRS-2002 score, it emerges that Group1 showed a higher average score (therefore a higher risk of malnutrition) than Group2 in both categories of this instrument, i.e. Pre-Screening average Score (0,9 vs 0,7) and NRS average Score (1,73 vs 1,26), as it was expected. The difference between the two groups was also demonstrated with the average scores of CONUT (2,54 vs 2,3) and PNI (44,9 vs 45,5).

Conclusions

NRS-2002, PNI, and CONUT have proven useful in identifying nutritional risk in patients with digestive cancer. Compared to PNI and CONUT, NRS-2002 could be a more appreciated tool by nurses and patients because it does not require invasive manoeuvres (i.e. blood sampling) and is easier to calculate. Further studies are needed to confirm the data.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

K. Ballfusha.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.