A retrospective study on nutrition risk assessment and nutritional management of head and neck cancer patients undergoing surgery in a tertiary care teaching hospital

Abstract Head and neck cancer (HNC) patients often face diverse nutritional challenges before, during, and after cancer treatment. Malnutrition, sarcopenia, and likely unintentional weight loss during treatment are associated with compromised quality of life, inferior treatment outcomes, and increased morbidity; even in patients whose body mass index (BMI) is not a good indicator of malnutrition. The objectives of this study were to detect nutritional risk in HNC patients undergoing surgical intervention and assess the dietary interventions done accordingly. Work planned to document the patient’s clinical condition, assess the nutrition risk by Nutrition Risk Screening (NRS) tool 2002, the diet given orally or via nasogastric tube as per the severity of malnutrition, surgical complications, primary etiology, infections, and other secondary causes of malnutrition. A total of 70 subjects were selected by simple random sampling from the list of all HNC patients discharged or transferred from the Otorhinolaryngology intensive care unit (ICU) during the period from July 2023 to December 2023. Bedhead tickets and ancillary documents retrieved from the Medical Records Section served as source documents. The average BMI of 70 patients was 20.4 (standard deviation = 3.04) kg/m 2 , and they were distributed as 34% underweight, 46% normal, 13% overweight, and 7% obese at admission. NRS 2002 indicated that 100% were at nutrition risk (score 5 or 6) following surgery as they were all in ICU and because of comorbidities. Dietary supplementation along with kitchen feed had been introduced to these patients, as soon as permissible after surgery, and gradually increased as per requirement. However, most required Ryle’s tube feeding (85.71%), and 82.86% of patients were placed on a high-protein diet initially. The nutrition care process (NCP) was continued under the dietician’s supervision throughout the hospital stay. Supervised NCP is essential for HNC cancer patients in the postsurgical period as all are at high nutrition risk, irrespective of BMI, and require ICU stay. Feeding challenges must be met in addition to recommending a diet appropriate to the current nutritional status.