Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Head Neck. 2013 Mar;35(3):436-42. doi: 10.1002/hed.22992. Epub 2012 May 18.
Evidence-based nutritional and swallowing guidelines were developed to identify patients at high risk of developing malnutrition during chemoradiation for head and neck cancer. These guidelines recommended a prophylactic gastrostomy and were actively implemented at our institution in January 2007. This study assesses the effect of this policy change on patient outcomes.
This retrospective cohort study was carried out for the years before (2005) and after (2007) implementation of these guidelines.
In all, 165 patients were treated with radical chemoradiation for head and neck cancer at our institution in the years 2005 and 2007. Gastrostomy tube complications were low. Patients in 2007 had significantly fewer hospital admissions, unexpected admissions, and a shorter mean duration of hospital stay in comparison with those in 2005.
Prophylactic gastrostomy tubes in patients with high-risk head and neck cancer resulted in a significant decrease in hospital admissions and length of stay, and led to increased bed availability.
循证营养和吞咽指南的制定旨在识别头颈部癌症放化疗期间发生营养不良风险较高的患者。这些指南建议对这些高危患者行预防性胃造瘘术，并且该建议在我院于 2007 年 1 月开始积极实施。本研究评估了这一政策变化对患者结局的影响。
本回顾性队列研究对指南实施前（2005 年）和实施后（2007 年）进行。
我院在 2005 年和 2007 年共对 165 例头颈部癌症患者行根治性放化疗。胃造瘘管并发症发生率低。与 2005 年相比，2007 年患者的住院次数、非预期住院次数和平均住院时间均显著减少。
对高危头颈部癌症患者行预防性胃造瘘术可显著减少住院次数和住院时间，增加床位可用性。
