[The incidence of the refeeding syndrome in cancer patients who receive artificial nutritional treatment].
We determine the incidence of the malnutrition syndrome and its relation with probable risk factors, in 106 patients, with a mean age of 53.3 +/- 15.4 years, with a diagnosis of cancer confirmed histologically, and who received artificial nutrition either enterally or endovenously, during an average of 16.8 +/- 2 days, which included a supply of 60 to 100 mmol/day of phosphorus. We considered there to be a renutrition syndrome when there as hypophosphatemia; < 2.5 mmol/l, which took place during the nutritional treatment phase, and previous to which, the patients had normal serum levels of phosphorus. The serum electrolyte concentrations were measured prior to the start of the treatment, and daily during the first week, and later every 3 days until the end. The study variables were: age, sex, type of cancer, degree of malnutrition, degree of hypophosphatemia, day on which in occurred, and clinical manifestations associated to this. The relative risk was calculated for the variables of age, sex, malnutrition and cancer. The incidence of the renutrition syndrome was 24.5%; it was more frequent in the enteral group than in the endovenous group (37.5% vs. 18.9%, p < 0.005); and it took place 72 hours after starting the nutritional support, in 61.5% of the cases, with a mean phosphorus concentrations of 1.9 mmol/l; the most frequent clinical manifestations were the neuromuscular ones (30%), and the most frequent type of cancer was lymphoma (15.4%). The risk factors were age greater than 60 years (RR = 1.7), and moderate or severe malnutrition 8RR = 2.0). We conclude that the prevalence of the renutrition syndrome is high in the cancer patients, despite an intense preventive treatment with phosphorus.
González Avila
G
G
Departamento de Medicina Interna y Apoyo Nutricio, Hospital de Oncología, Centro Médico Nacional Siglo XXI, México.
Fajardo Rodríguez
A
A
González Figueroa
E
E
D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000628:therapy; D018529:Nutritional Support / Q000009:adverse effects* / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D013577:Syndrome; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000453:epidemiology* / Q000209:etiology
Incidencia de síndrome de realimentación en enfermos con cáncer que reciben tratamiento nutricio artificial.