A Multi-Site, International Audit of Malnutrition Risk and Energy and Protein Intakes in Patients Undergoing Treatment for Head Neck and Esophageal Cancer: Results from INFORM

• Published in: Nutrients Vol. 14; no. 24; p. 5272
• Main Authors: Martin, Lisa, Findlay, Merran, Bauer, Judith D, Dhaliwal, Rupinder, de van der Schueren, Marian, Laviano, Alessandro, Widaman, Adrianne, Baracos, Vickie E, Day, Andrew G, Gramlich, Leah M
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.12.2022; MDPI
• Subjects: Audits; Body mass; Body weight; Body weight loss; Cancer therapies; Care and treatment; Case reports; Diagnosis; Dietitians; Energy; Enteral feeding; Enteral Nutrition; Esophageal cancer; Esophageal diseases; Esophageal Neoplasms; Esophagus; Food; Foregut; foregut tumors; Head & neck cancer; Head and neck cancer; Head and Neck Neoplasms - therapy; Health care access; Humans; Intervention; Lean body mass; Longitudinal Studies; Malnutrition; Malnutrition - diagnosis; Metabolism; Nutrition; Nutrition Assessment; nutrition care; nutrition risk; Nutritional Status; Ostomy; Parenteral nutrition; Patients; Prescriptions; Prevention; Prognosis; Prospective Studies; Proteins; Risk; Risk factors; Symptom management; Tube feeding; Tumors; Canada; Australia; United States > US; energy intake; enteral nutrition; malnutrition; esophageal cancer; head and neck cancer; nutrition risk; nutrition care; foregut tumors; patient-generated subjective global assessment; nutrition support
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14245272

Patients with foregut tumors are at high risk of malnutrition. Nutrition care focuses on identifying individuals at risk of malnutrition and optimizing nutrient intake to promote the maintenance of body weight and lean body mass. This multi-center prospective, longitudinal study audited nutrition care practices related to screening for risk of malnutrition (Patient-Generated Subjective Global Assessment Short Form; PG-SGA SF), and nutrition interventions prescribed (route; adequacy of energy and protein intakes). Audits occurred at four time periods: baseline (before treatment) and at 2, 4, and 6 months after starting cancer treatment; 170 patients (esophageal (ESO; n = 51); head and neck (HN; n = 119)) were enrolled. Nutrition risk (PG-SGA SF score ≥ 4) was prevalent at every time period: HN (baseline: 60%; 6 months 66%) and ESO (77%; 72%). Both groups had significant (p < 0.001) weight losses over the 6 month audit period (HN = 13.2% ESO = 11.4%). Enteral nutrition (EN) was most likely to be prescribed at 2 months for HN and at 4 and 6 months for ESO. Target prescribed energy and protein intakes were not met with any nutrition intervention; although adequacy was highest for those receiving EN. Nutrition care practices differed for HN and ESO cancers and there may be time points when additional nutrition support is needed.