Patients with head and neck cancer have known high rates of malnutrition. Malnutrition in this population has significant adverse impacts on clinical, cost and patient centred outcomes1. Malnutrition rates between 30-50% at diagnosis have been reported in the literature1. Evidence based practice guidelines recommended malnutrition screening at diagnosis, using a validated tool such as the Malnutrition Screening Tool (MST), to identify those at nutritional risk1. Routine malnutrition screening, performed by the dietitian, was implemented at the Gold Coast University Hospital (GCUH) Multidisciplinary Head and Neck Clinic in 2014. Patients who attend this clinic are seen by specialist physicans, dietitian, speech pathologist and cancer nurse prior to the clinic providing a recommendation for their care plan. This clinic is the largest of its kind south of Brisbane and north of Newcastle. The aim of this study was to determine the prevalence of malnutrition risk in patients attending this clinic.
MST score (total) was extracted from the electronic medical record of patients that attended the Multidisciplinary Head and Neck Clinic between May 2014 and August 2016.
A total of 452 patients attended 49 multidisciplinary head and neck cancer clinics. Malnutrition risk as determined by the MST score was present in 12.4% of patients. A large volume of patients (N=383, 84.7%) were deemed not at malnutrition risk according to the MST score. Less than 3% of patients that attended clinic were unable to be screened.
The results demonstrate that the majority of patients who attended clinics were not at risk of malnutrition at this time point according to the MST. Despite this, the future high risk of malnutrition in patients receiving anti-cancer treatments (i.e. surgery, radiation, systemic therapies) to the head and neck is well established and dietitian referral is still warranted.