Recently, the Global Leadership Initiative on Malnutrition (GLIM) criteria were proposed to standardize the diagnosis of malnutrition. We aim to determine the nutritional status and the prevalence of malnutrition in cancer inpatients as measured by GLIM criteria, and establish the association between malnutrition with the risk of nosocomial infections (NI) and length of hospital stay.
Prospective observational study carried out in patients admitted to Oncology Department of General University Hospital of Valencia from November 2019 to March 2020. Nutritional status was evaluated within the first 48 hours after admission. Fat free mass index (FFMI) and phase angle (PA) was measured using a bioelectrical impedance (Akern®), and muscle function using a Jamar® handgrip. Sarcopenia was measured using the cut-off values according to EWGSOP2.
A total of 107 patients were evaluated (mean age 66 years, 66.4% males). Most patients (70.1%) had an advanced disease. On admission, 48 patients (44.9%) presented severe malnutrition and 19 (17.8%) moderate malnutrition based on GLIM criteria. In addition, 77 patients (72%) presented dynapenia and 18 patients (16.8%) sarcopenia. Other parameters of nutritional status were: mean weigh: 67.8 kg, mean BMI: 24 kg/m2, mean FFMI: 18.6 kg/m2 and mean PA: 4.5º. Mean length of stay was 13.9 days. During admission, 43 patients (40,2%) developed a NI, mostly respiratory tract infections (26 patients). Weigh, BMI and FFMI but not PA was significantly lower in patients who developed a NI (p<0.05 in all cases). The proportion of infections was higher in patients with severe malnutrition (25/48, 52.1%) and moderate malnutrition (8/19, 42.1%) as compared with patients with no malnutrition (10/40, 25%), (p=0,035). NI were more common in patients with sarcopenia (61.1% vs. 36%, p=0,044). Length of stay was longer in infected patients (18.6 vs 10.8 days, p<0,024) but was not related to nutritional status.
The prevalence of malnutrition in cancer inpatients is high. Malnutrition measured by GLIM criteria and sarcopenia are associated with a high risk of NI. An adequate nutritional evaluation is essential for a timely implementation nutritional support, to avoid malnutrition, sarcopenia and decrease NI.
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All authors have declared no conflicts of interest.