Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial
| Autor: | Filomena Gomes, Philipp Schuetz, Christoph Henzen, Laura Bargetzi, Jaques Donzé, C. Brack, Michael Brändle, Robert Thomann, Sarah Sigrist, Vojtech Pavlicek, Nicolas Rodondi, Stefan Bilz, Mario Bargetzi, Claus Hoess, Drahomir Aujesky, Alessandro Laviano, J. Herrmann, Beat Mueller, Annika Bargetzi, Pascal Tribolet, Jonas Rutishauser, Zeno Stanga, Lara Hersberger, Nina Kaegi-Braun |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 610 Medicine & health law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life law 360 Social problems & social services Internal medicine Multicenter trial medicine Clinical endpoint Risk of mortality Humans Prospective Studies business.industry Nutritional Support Hazard ratio Cancer Hematology Odds ratio Length of Stay medicine.disease 030104 developmental biology Oncology 030220 oncology & carcinogenesis Hematologic Neoplasms Quality of Life business |
| Zdroj: | Bargetzi, L; Brack, C; Herrmann, J; Bargetzi, A; Hersberger, L; Bargetzi, M; Kaegi-Braun, N; Tribolet, P; Gomes, F; Hoess, C; Pavlicek, V; Bilz, S; Sigrist, S; Brändle, M; Henzen, C; Thomann, R; Rutishauser, J; Aujesky, D.; Rodondi, N.; Donzé, J.; ... (2021). Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: Secondary analysis of a prospective randomized trial. Annals of oncology, 32(8), pp. 1025-1033. Elsevier 10.1016/j.annonc.2021.05.793 |
| ISSN: | 1569-8041 |
| Popis: | Background Nutritional support in patients with cancer aims at improving quality of life. Whether use of nutritional support is also effective in improving clinical outcomes requires further study. Patients and methods In this preplanned secondary analysis of patients with cancer included in a prospective, randomized-controlled, Swiss, multicenter trial (EFFORT), we compared protocol-guided individualized nutritional support (intervention group) to standard hospital food (control group) regarding mortality at 30-day (primary endpoint) and other clinical outcomes. Results We analyzed 506 patients with a main admission diagnosis of cancer, including lung cancer (n = 113), gastrointestinal tumors (n = 84), hematological malignancies (n = 108) and other types of cancer (n = 201). Nutritional risk based on Nutritional Risk Screening (NRS 2002) was an independent predictor for mortality over 180 days with an (age-, sex-, center-, type of cancer-, tumor activity- and treatment-) adjusted hazard ratio of 1.29 (95% CI 1.09-1.54; P = 0.004) per point increase in NRS. In the 30-day follow-up period, 50 patients (19.9%) died in the control group compared to 36 (14.1%) in the intervention group resulting in an adjusted odds ratio of 0.57 (95% CI 0.35-0.94; P = 0.027). Interaction tests did not show significant differences in mortality across the cancer type subgroups. Nutritional support also significantly improved functional outcomes and quality of life measures. Conclusions Compared to usual hospital nutrition without nutrition support, individualized nutritional support reduced the risk of mortality and improved functional and quality of life outcomes in cancer patients with increased nutritional risk. These data further support the inclusion of nutritional care in cancer management guidelines. |
| Databáze: | OpenAIRE |
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