Decreased hospital stay and significant cost savings after routine use of prophylactic gastrostomy for high-risk patients with head and neck cancer receiving chemoradiotherapy at a tertiary cancer institution

Background Evidence‐based nutritional and swallowing guidelines were developed to identify patients at high risk of developing malnutrition during chemoradiation for head and neck cancer. These guidelines recommended a prophylactic gastrostomy and were actively implemented at our institution in Janu...

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Published in:Head & neck 2013-03, Vol.35 (3), p.436-442
Main Authors: Hughes, Brett G. M., Jain, Vikram K., Brown, Teresa, Spurgin, Ann-Louise, Hartnett, Gemma, Keller, Jacqui, Tripcony, Lee, Appleyard, Mark, Hodge, Robert
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Cohort Studies
Cost Savings - statistics & numerical data
Female
Gastrostomy - adverse effects
Gastrostomy - methods
head and neck cancer
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - radiotherapy
Head and Neck Neoplasms - surgery
hospital admission
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
nutrition support
prophylactic gastrostomy
Retrospective Studies
Tertiary Healthcare
Treatment Outcome
Young Adult
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Summary:Background Evidence‐based nutritional and swallowing guidelines were developed to identify patients at high risk of developing malnutrition during chemoradiation for head and neck cancer. These guidelines recommended a prophylactic gastrostomy and were actively implemented at our institution in January 2007. This study assesses the effect of this policy change on patient outcomes. Methods This retrospective cohort study was carried out for the years before (2005) and after (2007) implementation of these guidelines. Results In all, 165 patients were treated with radical chemoradiation for head and neck cancer at our institution in the years 2005 and 2007. Gastrostomy tube complications were low. Patients in 2007 had significantly fewer hospital admissions, unexpected admissions, and a shorter mean duration of hospital stay in comparison with those in 2005. Conclusions Prophylactic gastrostomy tubes in patients with high‐risk head and neck cancer resulted in a significant decrease in hospital admissions and length of stay, and led to increased bed availability. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.22992