Thiamine deficiency in cancer patients at initial admission to a palliative care unit: a single-centre cross-sectional study

OBJECTIVES: Thiamine deficiency (TD) has been increasingly reported among patients undergoing active cancer treatment. However, its status in end-of-life cancer patients admitted to palliative care units remains unclear. This study aimed to determine the prevalence of TD and associated factors in end-of-life cancer patients on initial admission to a palliative care unit. METHODS: This single-centre descriptive cross-sectional study included end-of-life cancer patients admitted for the first time to a palliative care unit between 1 January 2020 and 31 December 2023. Whole blood thiamine concentrations measured on admission were analysed using high-performance liquid chromatography. The TD group was defined as <24.0 ng/mL and the thiamine normal group as 24.0-66.0 ng/mL. Patient characteristics were summarised using descriptive statistics, and factors associated with TD were examined using multivariable logistic regression, adjusting for age and clinical background variables. RESULTS: TD was identified in 85 (36%) of 234 patients. Multivariable logistic regression showed that only a serum albumin level <3.0 g/dL was significantly associated with TD (adjusted OR 2.05, 95% CI 1.10 to 3.90; p=0.023). Age, body mass index, Eastern Cooperative Oncology Group performance status, a history of chemotherapy within 1 month prior to admission and gastrointestinal malignancy were not significantly associated with TD. CONCLUSION: TD was identified in 36% of end-of-life cancer patients and found to be associated with serum albumin level. In end-of-life cancer patients, particularly those with low serum albumin levels, clinicians should be mindful of the possibility of TD.