Nutritional assessment of hospitalized patients with head and neck cancer

Nutritional assessment is an important part of the oncologic management of the cancer patient. Although it may be easy to identify weight loss, the criteria for negative energy balance are difficult to display in an ordinary clinical setting. In the present study we assessed the nutritional status and calculated the energy balance in 10 randomly selected cancer patients who were hospitalized at our ENT department. Loss greater than 10% of habitual weight was apparent in 5 patients, while only 2 of these had subnormal serum albumin levels. Another 1 of these patients with weight loss demonstrated reduced arm muscle circumference. Weight index, total body potassium and other anthropometric data did not significantly correlate with weight loss. Although supplementary nutrition was administered to most patients during hospitalization, only 4 patients were in positive energy balance as calculated from food tables. Only 2 out of 5 patients with a history of weight loss were in a positive energy balance. A questionnaire disclosed that insufficient considerations for the patients' food availability were shown. We conclude that malnutrition is a common and often an occult phenomenon in hospitalized patients. This may have an unfavorable influence on oncologic treatment and clinical outcome.