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The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy

Supportive Care in Cancer volume 28, pages 1441–1448 (2020)Cite this article

Abstract

Objectives

The aim of this study was to assess the association between malnutrition status with the (Global Leadership Initiative on Malnutrition) GLIM criteria and 1-year mortality in hospitalized patients with hematologic malignancy.

Methods

This study included 120 hospitalized patients with hematologic malignancy. Patients who were at risk of malnutrition with NRS2002 were reevaluated with the GLIM criteria for defined malnutrition. Also, the mid-upper arm circumference (MUAC), calf circumference (CC), and handgrip (HG) were measured, and albumin, C reactive protein (CRP), and total protein were recorded to assess malnutrition-related factors.

Results

A total of 120 patients are with lymphoma, leukemia, and myeloma having a rate of 34.2%, 34.2%, and 31.6%, respectively, and risk of malnutrition with NRS2002 was established in 82% of patients. Malnutrition with GLIM criteria was seen in 25.8% of patients. The 1-year mortality rate was 41.7% (n = 50). Malnutrition was associated with higher mortality risk independently with age and duration of diagnosis (HR 3.55 (1.99–6.34), p = 0.001). Low HG (HR 0.51 (0.26–0.99), p = 0.03), low albumin (HR 0.39 (0.2–0.6), p = 0.001), and high CRP (HR 2.39 (1.36–4.20), p = 0.002) were significantly associated with increased mortality risk. In contrast, BMI, MUAC, FFMI, and CC were not associated with higher mortality.

Conclusion

Malnutrition is high with the GLIM criteria. Hospitalized patients with hematologic malignancy with malnutrition have a higher 1-year mortality risk.

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Acknowledgments

The authors would like to thank the members of the Ege University Hospital Department of Internal Medicine, Division of Hematology (Nur Soyer, Filiz Vural, Mahmut Tobu, Murat Tombuloglu, Ayhan Donmez).

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Affiliations

  1. Department of Internal Medicine, Ege University Hospital, 35030, Izmir, Turkey

    Merve Yilmaz

  2. Division of Hematology, Ege University Hospital, Izmir, Turkey

    Fatos Dilan Atilla, Fahri Sahin & Guray Saydam

Authors
  1. Merve Yilmaz
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  2. Fatos Dilan Atilla
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  3. Fahri Sahin
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  4. Guray Saydam
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Contributions

MY designed the study and collected the data. MY and FDA analyzed the data and drafted the manuscript. FS and GS approved the final version of the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Merve Yilmaz.

Ethics declarations

The study was approved by the medical ethical review committee of Ege University and was carried out in accordance with the Declaration of Helsinki (ethical approval confirmation no:18-2/35).

Conflict of interest

The authors declare that they have no conflict of interest.

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Strengths of the study

Studies about malnutrition in cancer generally comprise patients with solid organ malignancy or hematopoietic stem cell transplantation (HSCT). In this study, we aimed to highlight the clinic importance of malnutrition defining with the new consensus GLIM diagnostic criteria for malnutrition in special group participants who have hematologic malignancy. All missing data were excluded from the study. Therefore, we believe that the data in our study are more representative of Turkish hospitalized patients with hematologic malignancy.

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Yilmaz, M., Atilla, F.D., Sahin, F. et al. The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy. Support Care Cancer 28, 1441–1448 (2020). https://doi.org/10.1007/s00520-019-04952-5

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  • DOI: https://doi.org/10.1007/s00520-019-04952-5

Keywords

  • Hematologic malignancy
  • Malnutrition
  • Mortality
  • GLIM criteria