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Nutritional parameters associated with hospital admissions in patients being treated for head and neck cancer

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Abstract

Purpose

This study analysed nutritional parameters (baseline body mass index (BMI), weight changes and enteral nutrition (EN) use, and their association with hospital admissions during radiotherapy in patients with head and neck cancer (HNC)).

Methods

A retrospective review of patients diagnosed with HNC and treated with radiotherapy between October 2012 and April 2014 was conducted. Data on each subject’s diagnosis, age, sex, chemotherapy, previous surgery, EN use, weight changes, and BMI were examined for their association with hospital admissions during treatment.

Results

Eighty-three patients were included, mean age (±standard deviation) = 61 (± 11 years). Thirty-four percent had self-reported weight loss at diagnosis, and mean BMI was 26.2 ± 5.3 kg/m2. Mean weight change during treatment was − 5.1 ± 6.2%. Ten patients used EN, with mean weight stabilisation during EN use (0.3 ± 5.1%). Higher presenting BMI, younger age, and definitive radiotherapy ± chemotherapy predicted greater weight loss (p < 0.05). Critical weight loss ≥ 5% was associated with a higher number of hospital admissions for nutrition reasons (n = 10) (p = 0.011) compared with those without critical weight loss (n = 2). EN use was associated with a higher number of nutrition-related admissions; however, it did not predict length of stay among those admitted.

Conclusion

Critical weight loss during radiotherapy was associated with unplanned nutrition-related hospital admissions. Higher BMI was associated with greater weight loss during radiotherapy, whilst EN use assisted in weight preservation. Further research around patient selection for nutritional interventions aimed at preventing critical weight loss and unplanned hospital admissions is needed.

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Acknowledgements

The authors thank Dr. Ian Nivison-Smith for his assistance with statistical analysis.

Funding

This work was supported by funding from The Kinghorn Cancer Centre (TKCC) Trust Fund and had no role in the design, analysis or writing of this article.

Author information

Authors and Affiliations

  1. Nutrition Services Department, St Vincent’s Hospital, Sydney, Australia

    Amanda M. Duffy

  2. Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia

    Amanda M. Duffy, Mark Halaki & Victoria M. Flood

  3. St Vincent’s Hereditary Cancer Clinic, The Kinghorn Cancer Centre, Sydney, Australia

    Allan Spigelman

  4. St Vincent’s Clinical School, UNSW, Sydney, Australia

    Allan Spigelman & Venessa Chin

  5. Department of Medical Oncology, The Kinghorn Cancer Centre, Sydney, Australia

    Venessa Chin

  6. Department of Otolaryngology- Head and Neck Surgery, St Vincent’s Hospital, Sydney, Australia

    Venessa Chin

  7. The Garvan Institute of Medical Research, Sydney, Australia

    Richard M. Gallagher

  8. Allied Health Research Unit, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia

    Victoria M. Flood

Authors
  1. Amanda M. Duffy
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  2. Mark Halaki
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  3. Allan Spigelman
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  4. Venessa Chin
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  5. Richard M. Gallagher
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  6. Victoria M. Flood
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Contributions

The authors’ contributions are as follows: AD was the principal investigator and contributed to the study design, conducted the data collection and analysis, interpretation of the findings and wrote the first draft of the manuscript. VF and MH contributed to the study design, data analysis, interpretation of the findings, and drafts of the manuscript. AS contributed to study support and design. RG and VC reviewed the medical treatment plans and contributed to the interpretation of findings.

Corresponding author

Correspondence to Amanda M. Duffy.

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The authors have no financial or personal conflicts of interest to declare. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

All authors read and approved the final version of the manuscript. The authors have no financial or personal conflicts of interest to declare.

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Duffy, A.M., Halaki, M., Spigelman, A. et al. Nutritional parameters associated with hospital admissions in patients being treated for head and neck cancer. Support Care Cancer 28, 341–349 (2020). https://doi.org/10.1007/s00520-019-04826-w

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  • DOI: https://doi.org/10.1007/s00520-019-04826-w

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