Nutritional assessment of cancer patients in palliative care is a key element for comprehensive care and survival

Abstract

Introduction: palliative care has been linked to the management of patients without a curative option. The detection of malnutrition allows establishing nutritional intervention strategies to make an adequate use of resources and contribute to support measures. Objective: to describe changes in nutritional status and their impact on survival in patients with cancer disease under palliative care. Methods: a descriptive observational study of a retrospective cohort. The patients had stage IV cancer disease, Karnofsky index ≤ 70 and a survival prognosis < 6 months. A complete nutritional assessment was carried out and they were followed for one year. Nutritional status and its characteristics, presence of cachexia, and median survival at one year were described. Results: of 256 patients at the beginning of follow-up, 60.9 % had some degree of malnutrition, which increased to 71.9 % at the end of fol-low-up. There was an increase in patients with a thin body mass index (BMI) (+7.6 %, p = 0.04) and a decrease in patients with excess weight (overweight:-3.6 %, p = 0.24; and obesity:-2.6 %, p = 0.17). Overall survival at 1 year was 60 % (95 % CI: 53-65). Conclusion: malnutrition was frequent in patients under palliative care (60.9 %) and increased throughout follow-up. Differences were observed between the complete nutritional diagnosis and BMI, which can lead to a misclassification of the diagnosis and a decrease in the effectiveness of cancer treatment.