SADA-11 A SCOPING REVIEW OF NUTRITIONAL STATUS IN THE CARE OF PATIENTS WITH METASTATIC SPINE DISEASE
Eli Johnson, Rafael De la Garza Ramos, Rapaële Charest-Morin, Scott L Zuckerman, Ilya Laufer, Nicholas Dea, Arjun Sahgal, Laurence Rhines, Ziya L Gokaslan, Chetan Bettegowda, Anne L Versteeg, Hanbo Chen, Netzer Cordula, Daniel Sciubba, John E O’Toole, Michael G Fehlings, Naresh Kumar, Alexander C Disch, Byron Stephens, Tony Goldschlager, Michael Weber, John Shin, , C Rory GoodwinAbstract
Introduction
Patients with metastatic spine disease (MSD) represent a unique and challenging sub-population of cancer patients with both potentially significant disease and severe functional impairments. Although the exact rate of malnutrition in the MSD population is unknown, it is estimated to be a comorbidity in the majority of these patients. We sought to review the literature on the diagnostics and treatment of malnutrition in the MSD population.
Methods
A literature search was conducted by the authors in PubMed/Medline, EMBASE, and Web of Science databases using keywords from the National Cancer Institute’s Nutrition in Cancer Care website. These terms included “malnutrition”, “weight loss”, “albumin”, “sarcopenia”, “muscle mass”, and “anorexia” among others. Studies were included if they involved patients with MSD and used clinical markers of nutritional status.
Results
A total of 61 studies were included and analyzed, 89% of which were retrospective. The total number of patients was 31,385 and surgery was the most common intervention. Serum albumin was the most common maker of nutrition (41 studies, 67%), followed by body weight/ BMI (21 studies, 34%), and muscle mass (17 studies, 28%). Outcomes examined included survival, length of stay, revision surgery, and functional status. With regard to correlating nutrition markers with outcomes – of the 47 studies examining albumin, 37 (79%) found a significant association between albumin and the studied outcome. In comparison, of the 21 studies using BMI as an indicator of nutrition, only 10% found this correlated with the studied outcome. A small portion of studies (n = 11, 18%) found no correlation between nutritional markers and the above outcomes on multivariate analyses.
Conclusion
Assessment of nutritional status in patients with MSD remains critical. Given the disparity of methods and associated outcomes in the literature, a consensus agreement on the assessment and definition of malnutrition in patients with MSD is needed.