This prospective cohort study developed and validated a simple bedside nomogram for predicting severe malnutrition in hospitalized patients with nasopharyngeal carcinoma (NPC). Using data from the Chinese INSCOC project, the researchers analyzed 216 NPC patients admitted between 2014 and 2019 to identify practical predictors of severe malnutrition without relying on laboratory testing.
The study found that 26.9% of patients were at nutritional risk according to the NRS 2002 screening tool, while 23.2% met criteria for severe malnutrition using the Patient-Generated Subjective Global Assessment (PG-SGA). Worsening nutritional status was strongly associated with poorer quality of life, including reduced physical, emotional, cognitive, and social functioning, as well as increased fatigue, appetite loss, pain, and insomnia.
Multivariate analysis identified three independent predictors of severe malnutrition: higher pain scores, lower triceps skinfold thickness (TSF), and elevated NRS 2002 scores. These variables were combined into a low-cost predictive nomogram that achieved strong discrimination, with area-under-the-curve (AUC) values of 0.903 in the training cohort and 0.825 in the validation cohort. The model was specifically designed for rapid bedside use in resource-limited settings because it does not require blood tests or complex diagnostic procedures.