Effect of Hospital to Home nutrition management model on postoperative clinical outcomes of patients with laryngeal carcinoma

摘要

The purpose of this investigation was to determine the effectiveness of a Hospital to Home (H2H) nutrition management model on the postoperative clinical outcomes of patients with laryngeal carcinoma. Eighty-six patients with laryngeal carcinoma were randomly divided into an observation (H2H nutrition management) or control group (routine nutrition management). The ratios of urine lactulose to mannitol (L/M) in serum orexin-A levels of patients in both groups on the 1st postoperative day were significantly higher than before surgery; these levels decreased from the 7th and 14th postoperative day, but remained higher than before surgery (p<0.05). There was no statistical difference in the L/M and orexin-A levels between the two groups before surgery and on the 1st postoperative day; those indexes were statistically decreased in the observation as compared to the control group on the 7th and 14th postoperative days. The nutritional status grades were evaluated using a Patient-Generated Subjective Global Assessment (PG-SGA) quantitative scoring at 3 months after surgery and showed that malnutrition rates were significantly lower in the observation as compared to the control group. Serum levels of hemoglobin (Hb), albumin (Alb), prealbumin (PAB) and transferrin (TRF), 3 months after surgery showed significantly lower Hb and Alb and significantly higher PAB and TRF levels in the observation compared to the control group. After one year follow-up, there were no significant differences in hospitalization time and cost between the two groups, but the postoperative complication, readmission and mortality rates in the observation group were significantly lower than that the control group. Each dimension score of quality of life in the observation group was significantly higher than the control group. In conclusion, the H2H nutrition management model can effectively improve the postoperative nutritional level of patients with laryngeal carcinoma, resulting in a lower rate of complication, readmission and mortality resulting in an improved patient's quality of life.