Application of nutritional screening tools in cancer outpatients with chemotherapy at Prapokklao Hospital, Chanthaburi Province

Abstract

Malnutrition is common in cancer patients and it is important to implement an appropriate nutritional screening tool to identify patients at risk. This observational, cross-sectional study was aimed to assess the nutritional status of the cancer outpatients with chemotherapy at Prapokklao Hospital, Chanthaburi Province. The nutritional screening tools used included Patient-Generated Subjective Global Assessment (PG-SGA), Mini-Nutritional Assessment (MNA) and Malnutrition Screening Tool (MST). The outcomes of application of each nutritional screening tool were compared. Moreover, nutritional status was assessed by anthropometry and laboratory measurement. The estimation of food intake of the patients was also performed. The prevalence of malnourished patients and nutrition impact symptoms from chemotherapy were determined. The nutritional screening was performed on 224 cancer patients. The prevalence of malnutrition determined by MNA and MST were higher than PG-SGA (76%, 46%, and 28% respectively), because MNA and MST had high sensitivity (95% and 89% respectively) and low to moderate specificity (32% and 71% respectively). For anthropometry and laboratory measurement, the results showed that most patients were in normal range. However, the patients in this study had inadequate dietary and energy intake. This might result from chemotherapy that had an effect on nutritional status. The most frequent and severe nutrition impact symptom found was anorexia. Moreover, the nutritional status assessed by each nutritional screening tool was correlated with anthropometric parameters, hemoglobin, energy requirement, and energy intake (p < 0.05). It was concluded that all nutritional screening tools were able to correctly classify malnourished patients. However, the results of this study showed that MST was effective in the screening of the malnourished cancer outpatients and continuing application of MST should be conducted in cancer outpatients with chemotherapy