Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Head Neck. 2013 Oct;35(10):1385-91. doi: 10.1002/hed.23146. Epub 2012 Sep 13.
The "Swallowing and Nutrition Guidelines for Patients with Head and Neck Cancer" were developed to guide early identification and management of dysphagia and nutritional risk before, during, and after cancer treatment. The purpose of this study was to validate these guidelines.
Patients attending a Combined Head and Neck Clinic at a major tertiary hospital in 2007 to 2008 were assessed using the guidelines, with high-risk category patients recommended for proactive gastrostomy. Data were collected on guideline adherence, gastrostomy tube insertion, and weight. Sensitivity, specificity, and positive predictive value were calculated for validation.
Proactive gastrostomy tubes were inserted in 173 of 501 patients (25%). Overall guideline adherence was 87%. High-risk category adherence was 75%. Validation outcomes were sensitivity 54%, specificity 93%, and positive predictive value 82%.
The risk categories in the guidelines are valid to assist early identification of swallowing and nutritional risk and guide decision-making on proactive gastrostomy tube insertion.
《头颈部癌症患者吞咽和营养指南》旨在指导癌症治疗前、治疗中和治疗后吞咽困难和营养风险的早期识别和管理。本研究的目的是验证这些指南。
2007 年至 2008 年，在一家主要的三级医院的联合头颈部诊所，对患者使用这些指南进行评估，建议高风险类别的患者进行积极的胃造口术。收集了指南遵循情况、胃造口管插入和体重数据。对验证进行了敏感性、特异性和阳性预测值的计算。
501 例患者中有 173 例（25%）插入了主动胃造口管。总体指南遵循率为 87%。高风险类别依从率为 75%。验证结果为敏感性 54%，特异性 93%，阳性预测值 82%。
指南中的风险类别可用于协助早期识别吞咽和营养风险，并指导积极胃造口管插入的决策。
