Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Clinical Nutrition, MianYang Central Hospital, Mianyang, Sichuan, China.
Cancer Med. 2024 May;13(10):e7288. doi: 10.1002/cam4.7288.
This study aims to explore the effect of nutritional impact symptoms (NIS) on oral nutritional supplements (ONS) energy intake and use days among head and neck cancer (HNC) patients.
A cross-sectional study was conducted among HNC patients in a hospital in western China between January 2019 and June 2020. The NIS was from the Patient-Generated Subjective Global Assessment (PG-SGA) scale. Mann-Whitney test was used to examine the differences between different kinds of NIS and ONS use days. Binary logistic regression was used to determine the effect of NIS on ONS energy intake.
The most prevalent four NIS were no appetite (35.3%), dysphagia (29.4%), vomiting (13.2%) and oral pain (12.5%), respectively. All patients in the study were malnutrition. Patients with xerostomia or oral pain had less ONS use days than those without these symptoms. Patients with vomiting (OR 0.09, 95% CI 0.02-0.50) or pain (OR 0.15, 95% CI 0.02-0.89) were less likely to have ONS energy intake ≥400 kcal/day than those without these symptoms after adjusting the confounding factors. In addition, one-point increase in total NIS score was associated with a lower proportion of ONS energy intake ≥400 kcal/day (OR 0.77, 95% CI 0.59-0.99).
Xerostomia, oral pain, vomiting and pain should be strengthened and intervened to improve ONS use and nutritional status among HNC patients with malnutrition.
本研究旨在探讨营养相关症状(NIS)对头颈部癌症(HNC)患者口服营养补充(ONS)能量摄入和使用天数的影响。
本研究采用横断面研究方法,于 2019 年 1 月至 2020 年 6 月在中国西部某医院调查 HNC 患者。NIS 采用患者自评主观全面评估(PG-SGA)量表进行评估。采用 Mann-Whitney 检验比较不同 NIS 与 ONS 使用天数之间的差异。采用二项逻辑回归确定 NIS 对 ONS 能量摄入的影响。
最常见的四种 NIS 依次为无食欲(35.3%)、吞咽困难(29.4%)、呕吐(13.2%)和口腔疼痛(12.5%)。所有患者均存在营养不良。口干或口腔疼痛的患者 ONS 使用天数少于无这些症状的患者。校正混杂因素后,有呕吐(OR 0.09,95%CI 0.02-0.50)或疼痛(OR 0.15,95%CI 0.02-0.89)的患者 ONS 能量摄入≥400kcal/d 的可能性低于无这些症状的患者。此外,NIS 总分增加 1 分与 ONS 能量摄入≥400kcal/d 的比例降低相关(OR 0.77,95%CI 0.59-0.99)。
口干、口腔疼痛、呕吐和疼痛应得到加强和干预,以改善营养不良的 HNC 患者的 ONS 使用和营养状况。