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◆ Clinical Nutrition ESPEN2026-05-09· Medicine

Malnutrition at hospital admission as a predictor of increased risk of intensive care unit admission and in-hospital mortality in patients undergoing hematopoietic stem cell transplantation: A prospective observational cohort study

Carolina Oliveira Dos Santos, Caroline Raquel da Silva Severo, Samanta Catherine Ferreira, Valeska Moraes Gonçalves, Rafaela Festugatto Tartari, Catarina Bertaso Andreatta Gottschall

原始摘要(英文原文)· Original abstract
BACKGROUND: The conditioning regimen for hematopoietic stem cell transplantation (HSCT) has adverse effects that impair nutrition and contribute to malnutrition. OBJECTIVE: To evaluate the nutritional status of patients undergoing HSCT before and after the procedure and its association with clinical outcomes during hospitalization. METHODS: Prospective observational cohort study including adults (≥18 years) admitted for HSCT. Nutritional status was assessed within 72 h of admission (pre-HSCT) and 14 days later (post-HSCT) using the Patient-Generated Subjective Global Assessment (PG-SGA). Clinical outcomes were collected from electronic medical records until discharged. RESULTS: A total of 117 patients (median age: 56 years) were evaluated. Most underwent autologous transplantation (70.1%) and received non-myeloablative conditioning (69.2%). The median length of stay was 24 days; 12% required ICU care and 9.4% died during hospitalization. At pre-HSCT, 84% of patients were classified as well-nourished by PG-SGA. However, by post-HSCT, 90% experienced deterioration in nutritional status. Diarrhea and loss of appetite were the most frequent symptoms impacting nutrition. Pre-HSCT malnutrition was identified as an independent predictor of worse clinical outcomes. After adjustment for confounding variables, malnourished patients at admission had a 3.65-fold increased risk of hospital mortality (OR 3.65; CI 1.22-10.91) and a 3.32-fold higher likelihood of ICU admission (OR 3.32; CI 1.30-8.48). CONCLUSION: Patients undergoing HSCT showed a significant decline in nutritional status during hospitalization. Pre-HSCT malnutrition was independently associated with increased risk of ICU admission and in-hospital mortality, highlighting the importance of early nutritional assessment and intervention in this population.
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Malnutrition at hospital admission as a predictor of increased risk of intensive care unit admission and in-hospital mortality in patients undergoing hematopoietic stem cell transplantation: A prospective observational cohort study — 科研速览 Science Skim