Kim Bo-Eun, Kim Eun-Hye, Baek Chung-Hwan, Lee Kyung Won, Kim Yuri
Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea.
Department of Dietetics, Samsung Medical Center, Seoul 06351, Korea.
Nutr Res Pract. 2025 Jun;19(3):397-411. doi: 10.4162/nrp.2025.19.3.397. Epub 2024 Dec 18.
BACKGROUND/OBJECTIVES: Malnutrition is associated with postoperative complications and delayed recovery in patients with head and neck cancer (HNC). This study investigated the effect of fiber-containing low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (low-FODMAP) formula on the incidence of gastrointestinal (GI) complications with tube feeding after HNC surgery.
SUBJECTS/METHODS: This retrospective study included 152 tube-fed patients who received nutritional support team care after undergoing surgery for HNC. The differences in nutritional status, nutrition supply, and length of hospital stay were compared according to tube feeding-associated GI complications. The receiver operating characteristic (ROC) curve was generated between Prognostic Nutritional Index, Nutritional Risk Index, a Nutrition Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) as the reference standard. The correlation between changes in the fiber-containing low-FODMAP formula and diarrhea incidence during tube feeding was evaluated.
Of 152 patients, 49.3% (n = 75) experienced GI complications during tube feeding. Patients with GI complications were hospitalized for approximately 10 days longer than those without complications. The prevalence rate of GLIM-defined malnutrition was 37.5% at admission. The percentage of patients at risk of developing malnutrition with NRS-2002 score ≥ 3 was 28.3% at admission. The area under the ROC curve of the NRS-2002 score for the GLIM diagnostic criteria for malnutrition was 0.908. The fiber-containing low-FODMAP formula change reduced the stool frequency in patients with diarrhea.
Our study findings provide essential data for establishing guidelines for selecting suitable formulas for tube-fed patients who have previously experienced diarrhea after HNC surgery.
背景/目的：营养不良与头颈部癌（HNC）患者的术后并发症及恢复延迟相关。本研究调查了含纤维的低可发酵寡糖、双糖、单糖和多元醇（低FODMAP）配方对HNC手术后管饲患者胃肠道（GI）并发症发生率的影响。
受试者/方法：这项回顾性研究纳入了152例接受HNC手术后接受营养支持团队护理的管饲患者。根据与管饲相关的GI并发症，比较营养状况、营养供给和住院时间的差异。以预后营养指数、营养风险指数、营养风险筛查2002（NRS - 2002）和全球营养不良领导倡议（GLIM）作为参考标准，绘制受试者操作特征（ROC）曲线。评估含纤维的低FODMAP配方变化与管饲期间腹泻发生率之间的相关性。
152例患者中，49.3%（n = 75）在管饲期间发生GI并发症。发生GI并发症的患者比未发生并发症的患者住院时间长约10天。入院时GLIM定义的营养不良患病率为37.5%。入院时NRS - 2002评分≥3的有营养不良风险的患者百分比为28.3%。NRS - 2002评分对于GLIM营养不良诊断标准的ROC曲线下面积为0.908。含纤维的低FODMAP配方变化降低了腹泻患者的大便频率。
我们的研究结果为制定指南提供了重要数据,该指南用于为HNC手术后曾经历腹泻的管饲患者选择合适的配方。
