Integration of Calf Circumference into Malnutrition Risk Tools to Predict Adverse Outcomes in Older Adults with Solid Tumors: A Secondary Cohort Study Analysis

Older cancer patients present a high risk of malnutrition and muscle loss, which can worsen outcomes and delay recovery. This study assessed whether combining nutritional risk screening tools with calf circumference (CC) measurements improves the prediction of hospital outcomes in older adults with solid tumors. A secondary analysis of 305 hospitalized cancer patients (mean age 68.2 ± 8.9 years; 59.3% male; 32.8% with gastrointestinal cancers) was conducted. Low CC was defined as ≤34 cm for men and ≤33 cm for women, with adjustments for body mass index ≥ 25 kg/m2. Nearly 60% of patients had low CC. The Mini Nutritional Assessment–Short Form, particularly when combined with low unadjusted CC, showed the highest accuracy and sensitivity among the screening tools for predicting hospital stays of five days or more. In adjusted analyses, patients identified as being at nutritional risk and presented with low CC had approximately twice the odds of experiencing prolonged hospitalization. No significant association was found with hospital readmissions. These findings underscore the importance of integrating anthropometric measures like CC with established nutritional screening tools to better identify older cancer patients at risk for extended hospital stays.