Prevalence of nutritional risk in a multicenter sample of hospitalized oncological patients in Ukraine: a cross-sectional study using PRONTO
Zub V.O.1, Matolinets N.V.2, Fediaieva S.I.2, Osynskyi D.S.3, Volkova N.O.4, Savenkov D.Yu.5, Serhiichuk D.T.6, Duda O.R.7, Hordiievych O.Yu.7, Avramets O.O.8, Adyrov M.V.9, Kuibida I.S.10
- 1National Association of Oncologists of Ukraine, Kyiv, Ukraine
- 2Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
- 3Kyiv City Clinical Oncology Center, Kyiv, Ukraine
- 4Kyiv Regional Oncology Dispensary, Kyiv, Ukraine
- 5Dnipro Regional Clinical Oncology Dispensary, Dnipro, Ukraine
- 6First Medical Union of Lviv, Lviv, Ukraine
- 7Lviv Oncology Regional Diagnostic and Treatment Center, Lviv, Ukraine
- 8Zhytomyr Regional Oncology Dispensary, Zhytomyr, Ukraine
- 9Odesa Regional Clinical Anticancer Center, Odesa, Ukraine
- 10Prykarpattia Clinical Oncology Center, Ivano-Frankivsk, Ivano-Frankivsk, Ukraine
Summary. Nutritional disorders are a common and clinically significant component of cancer progression and are associated with poorer clinical outcomes; however, in routine clinical practice nutritional risk often remains underestimated, particularly when assessment is based solely on body mass index (BMI). Objective. To assess the prevalence and clinical characteristics of nutritional risk among hospitalized cancer patients using the PRONTO. Materials and methods. A multicenter cross-sectional observational study was conducted in specialized oncology centers across different macroregions of Ukraine. The study included 2261 adult patients (≥18 years) with malignant neoplasms. Nutritional risk was assessed once at hospital admission using the PRONTO screening tool, which includes the assessment of unintentional weight loss, decreased appetite or food intake, and weakness/reduced physical strength. The presence of at least one positive response was defined as a positive screening result (PRONTO+). The prevalence of nutritional risk was analyzed according to age, sex, tumor localization, disease stage, treatment modality, and BMI. Results. PRONTO+ was identified in 61.9% (95% confidence interval (CI) 59.9–63.9) of hospitalized cancer patients. The highest prevalence of nutritional risk was observed among patients with esophageal cancer (91.2%; 95% CI 77.0–97.0), hematological malignancies (87.5%; 95% CI 75.3–94.1), and gastric cancer (85.8%; 95% CI 79.6–90.3). The highest frequency of PRONTO+ was recorded in patients receiving combined treatment (73.6%; 95% CI 67.8–78.7), while similarly high rates were observed among those undergoing radiotherapy (67.9%; 95% CI 61.0–74.1), surgery (61.5%; 95% CI 58.4–64.5), and chemotherapy (57.7%; 95% CI 54.4–61.0). Nutritional risk was detected across all disease stages and did not demonstrate a consistent increase with advancing stage. Among patients with PRONTO+, individuals with normal or elevated BMI predominated, whereas underweight patients represented only a small proportion of the cohort. However, when analyzed within BMI categories, the highest prevalence of PRONTO+ was observed among underweight patients (74.7%; 95% CI 64.0–83.1). Clinical manifestations of nutritional risk, including weight loss, decreased appetite, and weakness, were also frequently observed in overweight and obese patients. Weakness/reduced physical strength was the most common symptom among patients with PRONTO+ (86.4%). Conclusions. Nutritional risk is highly prevalent among hospitalized cancer patients in Ukraine and is observed across all BMI categories, including overweight and obesity, supporting the routine use of PRONTO and the integration of nutritional risk screening into the clinical care pathway of patients with cancer.
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