Impact of protein-energy malnutrition on inpatient mortality, healthcare cost and clinical outcomes among patients with head and neck cancer
Abstract
11064
Background:
Protein-energy malnutrition (PEM) is a critical issue among patients diagnosed with head and neck cancers (HNC), primarily due to the tumor's anatomical location, and treatment-related side effects. Here, we examine the impact of PEM on the clinical outcomes and healthcare costs among hospitalized patients with HNC.
Methods:
This retrospective cohort study was conducted using data from the National Inpatient Sample database. Data of adult patients admitted with a diagnosis of HNC from 2016 to 2020 were analyzed and stratified based on the presence of PEM. The primary outcome was inpatient mortality rate, secondary outcomes included length of hospitalization, total hospital charges and other medical outcomes.
Results:
A total of 729,095 patients with HNC were identified, of whom 174,000 (23.8%) had PEM, with a mean age of 65.5 years and whites (77%) being the predominant race. Among the 32,075 patients who died, 11,715 (4.4%) had PEM. PEM was associated with a higher risk of mortality (6.74% vs 3.67%; OR:1.84, 95%CI 1.73-1.95;
P
< 0.001). Patients with PEM had an increased length of hospitalization (8.9 vs 5.2 days; adjusted difference of 3.3 days; 95% CI 3.21-3.45;
P
< 0.001), and higher total hospital charges ($98,959 vs $71,449; adjusted difference of $27,715, 95% CI $23,864-27,565;
P
< 0.001). Additionally, the presence of PEM was associated with increased risk of several secondary outcomes including septic shock, intubation, acute kidney injury,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 729,095 participants or records.
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