Comparison of the effect of different nutritional testing methods on preoperative nutritional risk screening for patients with head and neck cancer

Abstract

Objective To explore the role of bioelectrical impedance analysis (BIA) and laboratory tests for nutrition related indicators in preoperative nutritional risk screening of patients with head and neck cancer. Methods Totally 131 patients with head and neck cancer were selected by convenient sampling method. The nutritional risk was screened by NRS 2002 nutritional risk screening scale. The bioelectrical impedance indexes were collected by human body component analysis instrument and the nutritional related laboratory indicators were collected by electronic medical records. Results The incidence of nutritional risk in patients with head and neck cancer before operation was 18.6% (22/131). Correlation analysis showed that nutrition-related laboratory indicators were not related to nutritional risk, while bioelectrical impedance indicators such as fat-free mass, skeletal muscle mass, bodi mass index (BMI), inorganic salt content, water content and protein content were significantly correlated with NRS 2002 screening results(r=-0.228- -0.183, P<0.05 or 0.01). Univariate analysis showed that BMI, fat-free mass, protein content, skeletal muscle mass, water content, pharyngeal cancer, lymphatic metastasis, and diabetes mellitus were risk factors for nutritional risk (t=-4.121-2.918, χ2=4.167, 6.353, 4.032, P<0.01 or 0.05). Multivariate analysis showed that lymphatic metastasis was the independent risk factors of nutritional risk. Conclusions Preoperative nutritional risk screening is required for patients with head and neck cancer, especially those with tumor located in the pharynx, lymphatic metastasis and diabetes mellitus. Bioelectrical impedance analysis can be used as a reference for preoperative nutritional risk screening of patients with head and neck cancer, and can provide specific questions about human body composition for patients with nutritional risk, so as to provide a clear direction for nutritional risk intervention and can be used as an evaluation method of intervention. It is recommended that bioelectrical impedance analysis can be used as an auxiliary tool for nutritional risk screening. Key words: Head and neck neoplasms; Electric impedance; Laboratory techniques and procedures; Nutrition assessment