Nutritional risk associated with mortality in cancer patients admitted to an intensive care unit: A descriptive study of a single center: Original Research

Abstract

Introduction: Critically ill patients with oncological diseases develop a severe metabolic response to aggression with a high degree of hypermetabolism, which constitutes an associated risk and affects the mortality of these patients. The objective of the present study was to measure the nutritional status of a group of cancer patients admitted to intensive care and establish an association with mortality.

Methodology: This retrospective observational study was conducted in the intensive care unit of the National Oncology Institute "Dr. Juan Tanca Marengo" - Guayaquil in September - 2017 / August -2018. The sample was nonprobabilistic of patients with a cancer diagnosis. The variables were age, sex, mortality, NUTRIC score, admission condition, type of tumor, APACHE and SOFA physiological scales, days of hospitalization, and some comorbidities. ROC curve, Spearman's Rho, and Chi² analyses were used to establish the association.

Results: A total of 176 cases were included, aged 57 years (IR 43-67). 113/176 women (64.2%). The mean APACHE score was 18 ±7.3, and the median SOFA score was 4.0 (IR 1.0 – 6.0). The most frequent type of cancer was gynecological, with 25% (44/176) of cases. Mortality was 19.9% (35/176). NUTRIC scores were higher in deceased patients (Me 6.00 (IR 5-9) vs Me 3.00 (IR 1-4); P<0.0001). The presence of a NUTRIC score >4 has a sensitivity of 74.3% (95% CI 56.7 – 87.5), a specificity of 80.9% (95% CI 73.4 – 87.0), a positive predictive value of 49.1% (95% CI 39.4 – 58.7) and a negative predictive value of 92.7% (95% CI 87.8 – 95.7) for the outcome of mortality

Conclusion: In this study, high modified NUTRIC score scores were strongly associated with mortality in critical cancer patients. High scores on the modified NUTRIC score test correlate with worse clinical condition at admission and more extended stay in the intensive care unit.