Nutrition outcomes following implementation of validated swallowing and nutrition guidelines for patients with head and neck cancer

Brown, Teresa, Ross, Lynda, Jones, Lee, Hughes, Brett and Banks, Merrilyn (2014) Nutrition outcomes following implementation of validated swallowing and nutrition guidelines for patients with head and neck cancer. Supportive Care in Cancer, 22 9: 2381-2391. doi:10.1007/s00520-014-2180-9


Author Brown, Teresa
Ross, Lynda
Jones, Lee
Hughes, Brett
Banks, Merrilyn
Title Nutrition outcomes following implementation of validated swallowing and nutrition guidelines for patients with head and neck cancer
Journal name Supportive Care in Cancer   Check publisher's open access policy
ISSN 1433-7339
0941-4355
Publication date 2014-09-01
Year available 2014
Sub-type Article (original research)
DOI 10.1007/s00520-014-2180-9
Open Access Status DOI
Volume 22
Issue 9
Start page 2381
End page 2391
Total pages 11
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract
Purpose

Head and neck cancer patients have a high risk of malnutrition and swallowing dysfunction. This study reports on adherence and nutrition outcomes with the use of local evidence-based guidelines for the nutrition management of patients with head and neck cancer, including placement of proactive gastrostomy tubes for high risk patients.

Methods

This study is a prospective observational audit in patients treated for head and neck cancer at a tertiary hospital from 2007 to 2008 (n = 539). Nutrition outcomes (weight, nutritional status and type of nutrition support) were compared for each nutrition risk category. Primary outcome was 10 % or more weight loss at 3 months post-treatment (n = 219).

Results

Overall adherence to the guideline tube feeding recommendations was 81 %. High risk patients had mean weight loss of 6 % on completion of treatment and 9 % at 3 months post-treatment, despite the majority having a proactive gastrostomy tube. Medium and low risk patients also lost weight over this time. Univariate analysis found that non-adherence to the guidelines was associated with weight loss at 3 months (p = 0.013). Multivariate analysis found overweight patients had 1.82 greater odds, and obese patients had 3.49 greater odds of losing weight (p = 0.021). Patients with significant weight loss at diagnosis had decreased odds of losing weight later (p = 0.011).

Conclusion

Clinically significant weight loss was still prevalent in this population despite proactive interventions. Predictors of weight loss support the evidence-based guidelines’ risk categories, and adherence was important to improve outcomes. Further research is required to determine the impact of significant weight loss in patients with high body mass index (BMI).
Keyword Head and neck cancer
Prophylactic gastrostomy
Enteral feeding
Nutritional status
Nutrition
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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Created: Mon, 26 Jan 2015, 00:08:35 EST by Lee Jones on behalf of School of Public Health