Score of “eat-ability” as a predictor of malnutrition in patients with gastrointestinal tract cancer: A pilot study

Abstract

Introduction: decreased food intake, loss of appetite, and dysphagia are relevant symptoms in patients with gastrointestinal tract (GIT) cancer. However, these symptoms have been isolated or indirectly assessed when comprising quality of life questionnaires or risk assessment tools. Objective: to determine whether a combined assessment of dysphagia, appetite and food intake may be used as a parameter of eat-ability (food capacity) in patients with GIT cancer. Methods: a cross-sectional pilot study on 41 patients with GIT cancer were evaluated using a score for “eat-ability” (SEA) as compared to the Patient Generated Subjective Global Assessment (PG-SGA), anthropometry and laboratory profile. Results: eleven (27%) patients had full eat-ability (SEA 0), three (7%) had moderate (SEA 1) and 27 (66%) had poor (SEA ≥ 2) eat-ability, which were significantly different, between upper and lower GIT tumors (p ≤ 0.05). By ROC curves, SEA 1 and ≥ 2 showed an 80% for both sensibility (95% CI: 0.48-0.95) and specificity (95% CI: 0.63-0.91) to PG-SGA (A and B), with an area under curve (AUC) of 0.79 (95% CI: 0.64-0.95) (p = 0.006). Patients with SEA ≥ 2 had a significant weight loss within three (p = 0.001) and six months (p < 0.001) when compared to patients with SEA 0 and 1. Mortality was also significantly higher (p = 0.01) among patients with critical food capacity by SEA (77%) in severely malnourished patients by PG-SGA (84%). Conclusion: by combining food intake, dysphagia and appetite assessment altogether, a reliable score clearly demonstrated compromised eating capacity affecting nutritional status of patients with GIT tumors at a higher risk for death.