Clinical dietitian presence is associated with a two-fold higher rate of nutritional intervention in hospitalized cancer patients: a cross-sectional study.

Authors

Aleksandra Kapała, Katarzyna Różycka, Agnieszka Surwiłło-Snarska, Ewelina Choromańska, Anna Gielecińska, Paulina Pawicka, Marcin Folwarski

Published in

Clinical nutrition ESPEN. Pages 105186. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

Malnutrition is common in hospitalized patients with cancer, yet guideline-recommended nutritional care is implemented inconsistently. We compared nutritional care processes in hospitalized patients with solid tumors on wards with and without a ward-based clinical dietitian. The primary objective was to assess receipt of nutritional intervention among patients meeting a predefined clinical indication. Secondary objectives were discharge nutritional recommendations, NRS-2002 documentation quality, and GLIM-defined malnutrition identification.
Single-center cross-sectional census study at a tertiary oncology hospital (October 2024). Of 1,382 hospitalized patients, 986 with solid tumors across 19 wards were included; hematological malignancies and sarcomas, treated almost exclusively on non-dietitian wards were excluded. The primary outcome was receipt of nutritional intervention (dietetic consultation, oral nutritional supplements, enteral or parenteral nutrition) among patients meeting an ESPEN-aligned clinical indication (NRS-2002 ≥3, GLIM-defined malnutrition, weight loss >10%, or age-adjusted low BMI). Multivariable logistic regression was adjusted for age, sex, tumor site and disseminated disease with cluster-robust standard errors.
Overall, 369 patients met the clinical indication. Patients on dietitian wards were twice as likely to receive nutritional intervention (adjusted rates 91.4% vs 45.2%; adjusted OR 17.32, 95% CI 6.42-46.72), consistently across sensitivity analyses. Discharge nutritional recommendations were also more frequent (78.7% vs 27.8%; adjusted OR 13.48, 95% CI 6.18-29.40). NRS-2002 documentation quality and GLIM-defined malnutrition identification were not independently associated with dietitian presence.
Ward-based dietitian presence was associated with a two-fold higher rate of nutritional intervention and more frequent discharge recommendations, but not with screening or diagnostic quality. The single-center, non-randomized design precludes causal inference and limits transportability; multicenter confirmation is needed.

PMID:
42854965
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

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