A Review of Unplanned Admissions in Head and Neck Cancer Patients undergoing Oncological Treatment

Abstract

Abstract Aim Non-surgical treatment for head and neck cancer (HNC) often results in severe toxicities, which are detrimental to 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. Methods 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 hospital. To test potential demographic and treatment predictors of inpatient admission, a multiple regression model was constructed using the end point measure (unplanned admission), as the dependent variable. Results A cohort of 216 patients were identified, 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, 18 of 26 admitted without prophylactic PEG required nasogastric tube feeding during their admission. Discussion 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 nutritional is required for patients with HNC who receive CRT.