Nursing management and prevention of malnutrition in the patient with head-neck cancer.

Abstract

This study aimed to estimate the prevalence of hypoalbuminemia in hospidalized elders before treatment for free flap plastic surgery after intervention for head-neck cancer, their nutritional status and lenght of stay. Retrospective observational study with 28 patients with head and neck cancer who underwent free flap recostruction in hospital at the Galliera Hospital Genoa during two years from Jenuary 2017 to December 2018. Clinical and surgical procedure-related factors were retrieved from a database and analyzed. 28 patients ( 19 men, 9 women) were included in this study. The mean age of the study population was 61 years (range, 18 to 80 yr). The mean BMI was 23.30 kg/m2 ( range, 17.53 to 30.9 kg/m2). The mean lenght of stay was 35 days ( range, 11 to 122 days). The mean of the level albumin was 3.34 g/dl ( range, 2.1 to 4.5 g/dl). One surgical mortality was noted. The data emerged from the survey report the values of albumin and lymphocytes decreasing compared to the entrance, an extremely significant figure is also that of the days of hospitalization, which almost double in presence of one or more complications. The comparison between the average value of the days of stay of the stitches in patients without complications and the mean value of the days of stay of sutures in patients with complications, with a percentage deviation of 51.96%. The difference in patients with a lower incoming plasma albumin level compared to the group with normal levels allowed comparative analyses with respect to outcomes. 13 patients demonstrated albuminemia levels below the threshold of normal input, 15 adequate levels. The 13 patients with different albumenemic libellus developed site infection with an increase in average hospitalization days of 49.92 days (st.dev 26.26) against an average of the other group of 22.80 days (st.dev 10.50) the difference was significant The two-tailed P value equals 0.0011; also the permanence of the stitches in site is different between the two groups with an average of 45.77 days (st.dev 20.31) against an average of the other group of 23.80 days (st.dev 6.20) The two-tailed P value equals 0.0003 CONCLUSIONS: The prevalence of hypoalbuminemia, and the nutritional status and the length of stay seems to be related. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays.