Nutritional Status, Calorie Intake and Food Modification Among Esophageal, Head and Neck Cancer Patients Utilizing Gastrostomy Tube at Kenyatta National Hospital

Elizabeth Ndunge Kasimu; Gordon Nguka; Rose Shikuri

doi:10.37284/eajhs.8.1.3012

Elizabeth Ndunge Kasimu Kenyatta National Hospital
Gordon Nguka, PhD Masinde Muliro University of Science and Technology
Rose Shikuri, PhD Masinde Muliro University of Science and Technology

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Résumé

Esophageal, head and neck cancers (EC and HNC) significantly impair swallowing and ingestion. These cancers affect the upper digestive and respiratory tracts and might make caloric intake and nutrition status difficult to maintain. Gastrostomy tubes are crucial for managing dysphagia, allowing delivery of modified food for optimal nutrition. Malnutrition affects 40-80% of patients, with 15% losing over 10% of body weight, contributing to a 20% mortality rate. This study aimed to determine nutritional status outcomes, calorie intake and food modification among EC and HNC patients utilizing gastrostomy tube at Kenyatta National Hospital (KNH). The study design used a prospective institutional-based cross-sectional study with an analytical component. It was carried out from October 2023 to March 2024 with a sample size of 103 respondents and determined the relationship between the study variables. The study was conducted in KNH at the Cancer Treatment Centre and Radiotherapy Clinic. It’s the largest referral hospital in East and Central Africa and handles all types of cancers. Data collection used a 24-hour recall and PG-SGA. Analysis used Statistical Package for Social Sciences software Version 25.0. Most participants (84.5%) were on modified food and 81.6% had low-calorie intake of < 500 Kcals. The mean age was 56.2 years, 61.2% were male, while 38.8% were female. The majority (56.3%) were underweight, 40.8% normal, and 2.9% overweight. The calorie intake was inadequate. It was evident that food modification was highly correlated with the poor nutritional status of the EC and HNC gastrostomy-fed clients. These findings highlight the need for enhanced nutrition support protocols and individualised dietary interventions in clinical practice. While purposive sampling enhanced relevance and accuracy, there was a possibility of recall bias from the 24-hour dietary recall, though questions were exhaustively asked to minimise this limitation

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Références

Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hütterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Mühlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, Preiser JC. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11- 48. https://doi.org/10.1016/j.clnu.2016.07.015

Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, Baptista G, Barazzoni R, Blaauw R, Coats A, Crivelli A, Evans DC, Gramlich L, Fuchs-Tarlovsky V, Keller H, Llido L, Malone A, Mogensen KM, Morley JE, Muscaritoli M, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1- 9. https://doi.org/10.1016/j.clnu.2018.08.002

Martinovic D, Tokic D, Puizina Mladinic E, Usljebrka M, Kadic S, Lesin A, Vilovic M, Lupi-Ferandin S, Ercegovic S, Kumric M, Bukic J, Bozic J. Nutritional Management of Patients with Head and Neck Cancer-A Comprehensive Review. Nutrients. 2023;15(8):1864. https://doi.org/10.3390/nu15081864

Zeidler J, Kutschan S, Dörfler J, Büntzel J, Huebner J. Impact of nutrition counseling on nutrition status in patients with head and neck cancer undergoing radio- or radiochemotherapy: a systematic review. Eur Arch Otorhinolaryngol. 2024;281(5):2195-2209. https://doi.org/10.1007/s00405-023-08375-1

Pham Van B, Nguyen Thi Thanh H, Le Thi H, Nguyen Le Tuan A, Dang Thi Thu H, Dang Viet D. Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer-A Study from Vietnam. Healthcare (Basel). 2021;9(3):289. https://doi.org/10.3390/healthcare9030289

Bossola M. Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: a narrative review. Nutrients. 2015;7(1):265-276. https://doi.org/10.3390/nu7010265

Silander E, Nyman J, Bove M, Johansson L, Larsson S, Hammerlid E. Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer: a randomized study. Head Neck. 2012;34(1):1-9. https://doi.org/10.1002/hed.21700

Garutti M, Noto C, Pastò B, Cucciniello L, Alajmo M, Casirati A, Pedrazzoli P, Caccialanza R, Puglisi F. Nutritional Management of Oncological Symptoms: A Comprehensive Review. Nutrients. 2023;15(24):5068. https://doi.org/10.3390/nu15245068

Susetyowati S, Kurniasari FN, Sholikhati AS, Hardianti M, Ekaputra E. Assessment of Nutritional Status in Patients with Head and Neck Cancer Before Radiotherapy: A Single-center, Cross-sectional Study. Medeniyet Med J. 2024;39(1):24- 32. https://doi.org/10.4274/MMJ.galenos.2024.02448

Abu Zaid Z, Kay Neoh M, Mat Daud ZA, Md Yusop NB, Ibrahim Z, Abdul Rahman Z, Jamhuri N, Abdul Azim AZ. Weight Loss in Post-Chemoradiotherapy Head and Neck Cancer Patients. Nutrients. 2022;14(3):548. https://doi.org/10.3390/nu14030548

Wu, X. S., Miles, A., & Braakhuis, A. (2020). Nutritional intake and meal composition of patients consuming texture modified diets and thickened fluids: A systematic review and meta-analysis. Healthcare (Basel), 8(4), 579. https://doi.org/10.3390/healthcare8040579

Fisher, R.A., van Belle, G., & Martin, D.C. (1983). Biostatistics: A Methodology for the Health Sciences. Wiley-Interscience.