Bourdel-Marchasson et al developed a risk score for predicting one-year mortality for an older adult with cancer. This performed better than the Mini Nutritional Assessment (MNA) for accuracy of the prediction. The authors are from CHU Bordeaux, Bordeaux University, and Institut Bergonie in France.
Patient selection: > 70 years, cancer with indication for chemotherapy
Outcome: 1-year mortality
Parameter:
(1) food intake over the last 3 months
(2) number of prescription drugs per day
(3) protein-rich food intake
(4) calf circumference in cm
(5) cancer origin
(6) metastatic status
(7) absolute lymphocyte count
|
Parameter |
Finding |
Points |
|
food intake |
no decrease |
0 |
|
|
moderate decrease |
7.1 |
|
|
severe decrease |
13.4 |
|
prescription drugs |
0 to 3 |
0 |
|
|
>= 4 |
4.8 |
|
protein-rich food intake |
low |
10 |
|
|
intermediate |
5.2 |
|
|
high |
0 |
|
calf circumference |
< 31 cm |
11.3 |
|
|
>= 31 cm |
0 |
|
cancer |
non-small cell lung |
18.6 |
|
|
colon |
0 |
|
|
stomach |
10.4 |
|
|
ovary |
0.8 |
|
|
pancreas |
15.1 |
|
|
cholangiocarcinoma |
10.7 |
|
|
unknown |
7.0 |
|
|
prostate |
6.4 |
|
|
breast |
6.0 |
|
|
bladder |
13.8 |
|
metastasis |
no |
0 |
|
|
yes |
8.8 |
|
|
missing or undetermined |
8.4 |
|
lymphocyte |
>= 1,500 per µL |
0 |
|
|
< 1,500 per µL |
8.4 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 75.3
• The higher the score the greater the 1-year mortality/
• A score <= 21 had a one-year mortality of 20%. A score >= 31 had a one-year mortality of 70%.
Performance:
• The area under the ROC curve was 0.79.
• The calf circumference measurement has to be taken at the same site.
Specialty: Nutrition, Hematology Oncology
