Undernutrition as independent predictor of early mortality in elderly cancer patients

Abstract

The aim of this study was to evaluate the 1-y survival of elderly patients with cancer and the association between undernutrition and mortality. Methods: This was a cohort study with elderly patients ages 65 y admitted between September and October 2014. A nutritionist performed a Mini Nutritional Assessment-Short Form (MNA-SF) assessment during 48 h of hospital admission and collected data about potential confounding variables (comorbidities, stage of cancer, treatment in the previous 3 mo, and reason for hospi talization). Vital status was determined from the medical records or public records office. Overall survival was estimated using the Kaplan–Meier method. Cox regression was performed to estimate unadjusted hazard ratios. Variables with P < 0.20 by univariate analysis were selected for multi variate analysis. P < 0.05 was considered statistically significant. Results: Of the 136 patients (mean age, 73.1 y; 52.2% men), 29.4%, 41.2%, and 29.4% were classified as normal, at risk for undernutrition, and undernutrition, respectively, according to the MNA-SF. The mortality rate was 31.6% after 12 mo. One-year mortality was higher among the undernour ished patients, followed by patients at risk for undernutrition. After adjustment for confounding variables, the multivariate regression Cox model showed that being undernourished according to the MNA-SF increased the risk for death at 1 y (hazard ratio, 5.59; 95% confidence interval, 1.8–17.3; P < 0.001). Conclusion: The results showed that the MNA-SF can be a useful tool in identifying elderly patients at higher risk for 1-y mortality.