Association between mid-upper arm circumference and functional status in patients with advanced cancer

Abstract

Summary: Background: Patients with advanced cancer suffer from various physical and psychosocial distresses. With disease progression, anorexia was also a common symptom of distress in cancer patients. Eventually, prolonged anorexia and poor nutrition leads the deterioration of patients' performance statuses and quality of life as disease progress. Aims: This study aimed to identify direct correlations between performance status, symptom burden and mid-upper arm circumference (MUAC). Methods: This cross-sectional study was conducted with 200 patients between March 2016 and January 2019 at a tertiary cancer center in Korea. Results: A total of 65.5% of patients were on chemotherapy at enrollment, and 89.5% of the patients had a Karnofsky Performance Scale (KPS) of 70% or higher. Six items of the Korean Edmonton Symptom Assessment System (K-ESAS) (pain, fatigue, nausea, drowsiness, loss of appetite and feelings of wellbeing) showed a statistically significant negative correlation with MUAC (P<0.01) in the univariate analyses. Conversely, body mass index and KPS had a positive correlation with MUAC (P<0.01) in the univariate analyses. Finally, the KPS was significantly associated with the following three variables in the multivariate analysis: fatigue (P<0.01), feelings of wellbeing (P<0.01) in the K-ESAS and upper MUAC ≥26.5 cm group (P<0.01). Conclusion: The KPS had a significant relationship with MUAC, fatigue and feelings of wellbeing. Our study suggests that MUAC, as a simple and noninvasive tool played a vital role in functional statuses in patients with advanced cancer.

Keywords

• Mid-upper arm circumference
• Cancer symptoms
• Karnofsky performance scale
• Functional status