A review of unplanned admissions in head and neck cancer patients undergoing oncological treatment.



Fahy, Emer, Brooker, Rachel C, Fleming, Jason C ORCID: 0000-0001-7963-1224 and Patterson, Joanne M ORCID: 0000-0001-8898-8292
(2023) A review of unplanned admissions in head and neck cancer patients undergoing oncological treatment. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 31 (6). p. 328.

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Abstract

<h4>Aim</h4>Non-surgical treatment for head and neck cancer (HNC) often results in severe toxicities, which are detrimental to a patient's health and quality of life. There is limited published UK data on unplanned hospital admissions and reasons associated with admission. We aim to identify frequencies and reasons for unplanned hospital admissions, highlighting those patient groups who are most vulnerable.<h4>Methods</h4>A retrospective study of unplanned hospital admissions of HNC patients receiving non-surgical treatment was completed. An inpatient admission was defined as ≥ 1 night spent in the hospital. To test potential demographic and treatment predictors of inpatient admission, a multiple regression model was constructed using the endpoint measure (unplanned admission), as the dependent variable.<h4>Results</h4>A cohort of 216 patients was identified over a 7-month period, and 38 of these patients (17%) required an unplanned admission. Treatment type was the only statistically significant predictor of in-patient admission. The majority of admissions were patients receiving chemoradiotherapy (CRT) (58%) with predominant reasons for admission being nausea and vomiting (25.5%) and decreased oral intake/dehydration (30%). Of the patients admitted, 12 had a prophylactic PEG placed pre-treatment, and 18 of 26 admitted without prophylactic PEG required nasogastric tube feeding during their admission.<h4>Discussion</h4>Almost one-fifth of HNC patients over this time period required hospital admission; the majority of which can be attributed to treatment toxicities when receiving CRT. This is concurrent with other studies which review the impact of radiotherapy versus CRT. Increased support and monitoring, particularly focused on nutrition, are required for patients with HNC who receive CRT.<h4>Key message</h4>This article describes a retrospective review of a patient undergoing non-surgical treatment for head and neck cancer. These patients frequently require unplanned hospital admission. The results indicate that patients undergoing (chemo)radiotherapy are most vulnerable to deterioration and additional support focused on nutrition for these patients is indicated.

Item Type: Article
Uncontrolled Keywords: Unplanned admission, Head and neck cancer, Oncology, Chemoradiotherapy
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences
Depositing User: Symplectic Admin
Date Deposited: 15 May 2023 07:57
Last Modified: 31 May 2023 14:59
DOI: 10.1007/s00520-023-07770-y
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170310