Effectiveness of a Screening Tool for Early Identification of Malnutrition in Patients with Head and Neck Cancer

Abstract

The purpose of this study was to evaluate the impact of the Malnutritional Universal Screening Tool (MUST) assessment on effects of postoperative surgical site infection (SSI) and length of hospitalization stay (LOS) for patients undergoing oncologic resection for head and neck cancers. A pre-posttest design was used to evaluate the effects of preoperative nutritional screening on postoperative SSI and LOS rates in patients undergoing oncologic resection. A purposive sampling was used to recruit participants for the study. Pre- and post-implementation data were collected over a period of 8 weeks. All patients in the post-implementation group were assessed using the MUST and pre-surgery nutritional optimization was instituted. All participants were monitored for incidences of SSI until discharge. Of the 36 patients in the post-implementation group, 23(63.9%) had a MUST score of moderate to high and 13 (36.1%) had a score of low risk. There was a statistical significance observed between the pre-and post-implementation groups, with both postoperative surgical site infection (SSI) reduced from 50% to 22% and length of hospitalization stay from 28 to 17 days (p = 0.014) between the groups. Patients who were non-smokers (p = 0.010) and without reconstruction after surgery (p = 0.007) were less likely to develop postoperative SSI. Use of the MUST for preoperative nutritional screening has demonstrated that it is a feasible and easy to implement tool for assessment of malnutrition and it has demonstrated positive outcomes in reduction of both postoperative SSI and length of hospitalization stay.