Measuring malnutrition in gynaecologic oncology patients at King Edward Memorial Hospital (KEMH) – Pilot study

Mrs Pushpa Sivakumar1, Dr Yee Leung1, Mrs  Hanna Burbidge1, Ms Gemma Craven1, Ms Aimee Powell2,1, Mrs Valda Duffield1

1King Edward Memorial Hospital Wa, Subiaco, Australia, 2University of Western Australia, Nedlands , Australia

It is argued that a standard malnutrition-screening tool (MST) is not the most appropriate tool for gynecological-oncology patients due to the lack of consideration for gastrointestinal symptoms (nausea, vomiting, diarrhoea, constipation or ascites) that are commonly experienced in this cohort.

Nutrition and dietetics department in partnership with the gynecological-oncology department at King Edward Memorial Hospital aimed to identify the rates of malnutrition in gynecological-oncology patients. This is aligned with NHSQS 5 comprehensive care standards for nutrition and hydration. Our secondary aim was to establish the sensitivity and specificity of a Modified Malnutrition Screen Tool (MMST) in detecting malnutrition among this cohort.

This was a single centered prospective audit with 176 participants conducted between September 2020 to January 2021. All new gynecological-oncology patients referred to King Edward Memorial Hospital outpatient clinic were screened using an MST and MMST by the nursing staff. A dietitian completed a patient-guided subjective global assessment (PG-SGA) assessment of clinical signs of malnutrition on all consenting participants.

The final statistical analysis is pending, however, preliminary analysis found a malnutrition rate of 16% (determined as PG-SGA B and C). Of the 27 malnourished participants, 6 participants would have been misclassified as well-nourished if the MMST was not used. The MMST, containing one additional question relating to the presence of gastrointestinal symptoms, was a more specific and sensitive tool for detecting malnutrition among this gynecological-oncology cohort of patients.


Biography:

Pushpa has worked as a clinical dietitian for the past 18 years in Australia and prior to that in South Africa for 6 years. In Perth worked as a research dietitian at Curtin university for 3 years in couple of projects named “Postprandial Hypotension in older Australians” and Dairy calcium and weight loss”. Published both these projects in journal of Nutrition and dietetics by Dietitians Association of Australia 2006 to date working at KEMH as senior dietitian and currently HOD for Nutrition and Dietetics. I specialise in Obstetrics and gynaecology nutrition including diabetes in pregnancy, maternal obesity and metabolic problems in pregnancy.

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