Analysis of factors influencing nutritional risk in patients with acute leukemia and its correlation with psychological status

Table 1 Impact of general data on nutritional risk among patients

	Risk group (n = 81)	Non-risk group (n = 93)	χ2/t	P value
NRS2002	3.59 ± 0.61	1.18 ± 0.39	31.55	< 0.0001
Gender			0.333	0.564
Male	41	43
Female	40	50
Age (years)	48.09 ± 6.65	49.41 ± 6.47	1.328	0.186
BMI (kg/m2)	22.37 ± 2.94	23.24 ± 3.30	1.821	0.070
Educational level			10.622	0.005
Junior high school or below	29	32
Senior high school/technical secondary school	38	26
College and above	14	35
Personal monthly income (RMB)			4.278	0.039
≤ 3000	51	44
> 3000	30	49
Marital status			1.547	0.461
Unmarried	22	28
Married	43	41
Divorced/widowed	16	24
Occupational status			2.549	0.280
Unemployed	27	34
Employed	30	41
Retired	24	18
Disease perception			9.304	0.002
Good	30	56
Poor	51	37

NRS2002: Nutrition Risk Screening 2002; BMI: Body mass index.

Table 2 Impact of clinical data on nutritional risk in patients

	Risk group (n = 81)	Non-risk group (n = 93)	χ2/t	P value
Disease type			0.504	0.478
Leukemia lymphocytic	37	47
Myelocytic leukaemia	44	45
Disease stage			2.867	0.090
Initial treatment	47	42
Consolidation	34	51
Diabetes mellitus			0.584	0.445
Yes	21	29
No	60	64
Hypertension			0.140	0.709
Yes	24	30
No	57	63
Number of chemotherapy cycles (n)			6.745	0.009
≤ 3	26	48
> 3	55	45
Lowest hemoglobin level (g/ L)			12.872	0.002
< 60	37	19
60-90	29	52
> 90	15	22
White blood cell count (× 109/L)	13.20 ± 4.63	14.30 ± 5.43	1.429	0.155
Neutrophil count (× 109/L)	2.64 ± 0.77	2.87 ± 0.93	1.772	0.078

Table 3 Multivariate analysis of factors influencing nutritional risk in acute leukemia patients

Variable	β	SE	Wald	P value	HR	95%CI
Constant	-0.435	0.568	0.587	0.443	0.647	-
Educational level (0: Junior high school or below)	-	-	7.328	0.026	-	-
1: Senior high school/technical secondary school	0.382	0.404	0.894	0.345	1.464	0.664-3.230
2: College and above	-0.922	0.466	3.912	0.048	0.398	0.159-0.992
Personal monthly income (0: > 3000 yuan, 1: ≤ 3000 yuan)	0.142	0.365	0.150	0.698	1.152	0.563-2.357
Disease perception (0: Poor, 1: Good)	-0.710	0352	4.078	0.043	0.492	0.247-0.979
Number of chemotherapy cycles (0: ≤ 3 cycles, 1: > 3 cycles)	0.775	0.346	5.003	0.025	2.170	1.101-4.278
Lowest hemoglobin level (0: > 90 g/L)	-	-	11.741	0.003	-	-
1: 60-90 g/L	-0.297	0.447	0.440	0.507	0.743	0.309-1.786
2: < 60 g/L	1.061	0.473	5.026	0.025	2.890	1.143-7.307

HR: Hazard ratio; CI: Confidence interval.

Table 4 Anxiety and depression scores in acute leukemia patients

	Total score (n = 174)		Score	t	P value
SAS score	50.8 ± 8.08	Risk group (n = 81)	52.64 ± 6.92	2.754	0.007
		Non-risk group (n = 93)	49.68 ± 8.61
SDS score	52.59 ± 10.09	Risk group (n = 81)	56.15 ± 8.62	5.610	< 0.0001
		Non-risk group (n = 93)	50.36 ± 9.15

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 5 Patient psychological resilience scores

Item	Total score (n = 174)	Risk group (n = 81)	Non-risk group (n = 93)	t	P value
Total score of psychological resilience	69.59 ± 11.39	63.32 ± 8.95	75.04 ± 10.48	7.872	< 0.0001
Tenacity dimension	37.17 ± 8.15	33.81 ± 7.57	40.10 ± 7.51	5.482	< 0.0001
Self-reliance dimension	21.25 ± 5.45	19.38 ± 4.81	22.88 ± 5.47	4.451	< 0.0001
Optimism dimension	11.16 ± 2.87	10.12 ± 2.91	12.06 ± 2.53	4.707	< 0.0001

Table 6 Correlation between patient Nutrition Risk Screening 2002 scores and psychological status

Characteristic	NRS2002
	r	P value
SAS	0.170	0.025
SDS	0.372	< 0.0001
Tenacity dimension	-0.430	< 0.0001
Self-reliance dimension	-0.281	0.0002
Optimism dimension	-0.315	< 0.0001
Total score of psychological resilience	-0.521	< 0.0001

NRS2002: Nutrition Risk Screening 2002; SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 7 Multivariate analysis of psychological status on nutritional risk occurrence in patients

Variable	β	SE	Wald	P value	HR	95%CI
Constant	0.498	2.264	0.048	0.826	1.646	-
SAS	0.068	0.028	6.153	0.013	1.071	1.014-1.130
SDS	0.113	0.025	19.697	0.000	1.119	1.065-1.176
Tenacity dimension	-0.106	0.028	14.592	0.000	0.900	0.852-0.950
Self-reliance dimension	-0.135	0.042	10.530	0.001	0.874	0.806-0.948
Optimism dimension	-0.303	0.080	14.304	0.000	0.738	0.634-0.864

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale; HR: Hazard ratio; CI: Confidence interval.