Cheng et al identified variables associated with the need to place an enteral feeding tube in a patient with a head and neck cancer. This can help identify patients who may benefit from more aggressive nutritional management. The authors are from the University of Michigan and Veterans Affairs Ann Arbor Healthcare System.
Patient selection: adult with head and neck cancer
Enteral feeding tubes included nasogastric and gastrostomy tubes.
Parameters:
(1) tumor location
(2) tumor stage
(3) flap reconstruction
(4) tracheostomy
(5) chemotherapy
|
Parameter |
Finding |
Points |
|
location |
oropharynx or hypopharynx |
1 |
|
|
oral cavity, larynx, other |
0 |
|
tumor stage |
Stage I or II |
0 |
|
|
Stage III or IV |
1 |
|
flap reconstruction |
no |
0 |
|
|
yes |
1 |
|
tracheostomy |
absent |
0 |
|
|
present |
1 |
|
chemotherapy |
no |
0 |
|
|
yes |
1 |
total number of risk factors =
= SUM(points for all 5 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The risk of having an enteral feeding tube placed increases with the number of risk factors present.
• About a third of patients will have a feeding tube at 1 month after surgery, but this will decrease to 8% at 3 years. However, I am not sure if this data means that enteral feeding tubes are removed or that the more seriously ill patients have died.
|
Total Score |
Probability of Enteral Tube Placement |
|
0 |
0.6% |
|
1 |
10% |
|
2 |
18% |
|
3 |
26% |
|
4 |
59% |
|
5 |
> 59% |
Specialty: Nutrition, Gastroenterology, Critical Care
ICD-10: ,
