Malnutrition may increase hospital stay and postoperative complications in Head and Neck Cancer: JAMA

A retrospective study spanning over a decade uncovered alarming rates of malnutrition among patients undergoing head and neck cancer (HNC) surgery. The findings were published in the Journal of American Medical Association.

The study included 13,895 patients across 482 U.S. hospitals and utilized data from the Premier Healthcare Database. They focused on exploring the association between race, ethnicity, payer type, and perioperative malnutrition. Shockingly, malnutrition is significantly more prevalent among Black patients (adjusted odds ratio [aOR], 1.31), Medicaid-insured patients (aOR, 1.68), and Medicare-insured patients (aOR, 1.24), compared to their counterparts.

These malnutrition disparities have far-reaching consequences. Black patients and Medicaid-insured patients experienced prolonged hospital stays, higher costs, and an increased likelihood of postoperative pulmonary complications (PPCs), coupled with lower rates of being discharged to home.

The study, conducted between August 2022 and January 2023, reveals an independent association between malnutrition and adverse clinical outcomes. Perioperative malnutrition was independently linked to extended hospital stays (β, 5.20 additional days), elevated costs (β, $15,722 more cost), a higher likelihood of PPCs (aOR, 2.04), and reduced odds of being discharged to home (aOR, 0.34). However, no direct link between malnutrition and mortality was established.

The findings underscore the urgent need for targeted interventions to address malnutrition, especially in vulnerable populations. Strategies to mitigate these disparities in malnutrition risk must be integrated into the comprehensive care of HNC patients. By doing so, healthcare providers can potentially reduce hospital stays, cut costs, and enhance the overall postoperative recovery experience for these patients.

This comprehensive study sheds light on a previously underexplored facet of HNC care, emphasizing the imperative to address malnutrition disparities for a more equitable and effective approach to treatment. 

Source:

Reed, W. T., Jiang, R., Ohnuma, T., Kahmke, R. R., Pyati, S., Krishnamoorthy, V., Raghunathan, K., & Osazuwa-Peters, N. (2023). Malnutrition and Adverse Outcomes After Surgery for Head and Neck Cancer. In JAMA Otolaryngology–Head & Neck Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamaoto.2023.3486