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Mangelernährung bei Tumorpatienten

Ursachen, Diagnostik und Kodierung

Malnutrition in cancer

Pathophysiology and diagnostic concepts

Zusammenfassung

Ernährungsstörungen treten bei Tumorpatienten häufig bereits vor Diagnosestellung auf. Diese Defizite gefährden die Toleranz gegenüber Tumortherapien und schränken die Erkrankungsprognose ein. Ein tumorassoziierter Gewichtsverlust ist auch für Übergewichtige ungünstig, da er oft gerade die vitale Zellmasse betrifft. Eine zentrale Ursache für die Entstehung einer Mangelernährung ist eine tumorassoziierte systemische Inflammationsreaktion. Eine pathophysiologisch orientierte praktikable Diagnostik sollte regelmäßig Gewicht, Appetit, Essmenge und die Akutphasenreaktion erfassen. Veränderungen dieser Parameter werden als praktikable Definitionsmerkmale der kodierbaren zugehörigen DRG-Diagnosen vorgestellt. Eine verbindliche Einigung auf praktikable Definitionen der ernährungsrelevanten Diagnose-Codes liegt jedoch noch nicht vor.

Abstract

Nutritional deficits are frequent in cancer patients even before tumor diagnosis. These deficits increase the toxicity of cancer therapies and impair overall survival. Tumor-associated weight loss also has a negative impact in overweight individuals because of the often pronounced loss in body cell mass. An important cause of malnutrition is a tumor-associated systemic inflammatory response. The diagnostic approach should be simple and practical and follow the underlying pathophysiology; therefore, patients should be monitored regularly for weight, appetite, nutritional intake, and inflammatory response. Abnormalities in these parameters appear to be suited for defining diagnoses within the German DRG system.

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Arends, J. Mangelernährung bei Tumorpatienten. Onkologe 14, 9 (2008). https://doi.org/10.1007/s00761-007-1292-y

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Schlüsselwörter

  • Tumor
  • Mangelernährung
  • Anorexie
  • Kachexie
  • Ernährung

Keywords

  • Tumor
  • Malnutrition
  • Anorexia
  • Cachexia
  • Nutrition