Malnutrition screening in head and neck cancer patients with oropharyngeal dysphagia. (August 2021)

• Record Type: Journal Article
• Authors: Simon, Sorina R.; Pilz, Walmari; Hoebers, Frank J.P.; Leeters, Irene P.M.; Schols, Annemie M.W.J.; Willemsen, Anna C.H.; Winkens, Bjorn; Baijens, Laura W.J.
• Is Part Of: Clinical nutrition ESPEN. Volume 44(2021)
• Page Start: 348
• Page End: 355
• Publication Date: 2021-08
• Subjects: Malnutrition -- Dysphagia -- Deglutition -- Head and neck cancer; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2021.05.019
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background & aims: Malnutrition in head and neck cancer (HNC) patients is associated with increased morbidity and mortality. The purpose of this study is two-fold: to identify the risk of malnutrition in patients with oropharyngeal dysphagia (OD) secondary to HNC, and to determine the relationship between the risk of malnutrition versus tumor characteristics, treatment modality, time interval (between the end of oncological treatment and swallowing assessment date), level of oral intake, body mass index (BMI), aspiration, pharyngeal pooling, and OD-related quality of life (QoL). Methods: The Short Nutritional Assessment Questionnaire (SNAQ) was used to screen patients for the risk of malnutrition. Patients underwent a standardized swallowing examination protocol including an endoscopic evaluation of swallowing. Results: Seventy-five dysphagic HNC patients were included. Forty-eight percent of the patients presented a high risk of malnutrition using SNAQ. The majority of the patients (81.3%) was on a total oral diet. Moreover, BMI did not appear to be a reliable measure to screen for malnutrition as a normal BMI was often associated with an increased risk of malnutrition on the SNAQ. In contrast, patients who were underweight or overweight did not show an association with a high risk of malnutrition. With the exception of BMI, no other patient and tumor characteristics were found to be associated with the risk of malnutrition. Conclusions: This study emphasizes the importance of early nutritional screening in dysphagic HNC patients, as almost half of these patients presented a high risk of malnutrition. Malnutrition screening using SNAQ can identify HNC patients with OD who are at risk of malnutrition and subsequently need to be referred to a dietician for additional nutritional assessment, diagnosis of malnutrition, and nutritional support, even when their BMI is within normal range.