Effectiveness of Nutritional Screening Tools in Predicting the Impact of Malnutrition on Hospital and Intensive Care Unit Stay

Malnutrition commonly occurs in patients with esophageal cancer (EC) and head and neck cancers (HNCs), adversely affecting clinical outcomes. The comparative effectiveness of nutritional screening tools in predicting prolonged length of stay (PLOS) and intensive care unit (ICU) admission in this population remains unclear. We aimed to investigate the effectiveness of various nutritional screening techniques in predicting the hospital and ICU LOS of patients with HNCs/EC. We retrospectively analyzed the data of 374 patients aged ≥18 years with EC/HNC who underwent first-time surgery between January 2013 and December 2023. Nutritional status was assessed using the Malnutrition Universal Screening Tool (MUST), Controlling Nutritional Status (COUNT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI). Patients were classified into low-risk and high-to-moderate-risk groups. The outcomes included ICU stay >2 days and PLOS (>16 days). The COUNT, GNRI, and PNI were significantly associated with ICU stays >2 days and PLOS. The PNI had the highest predictive accuracy (ICU >2 days: adjusted odds ratio [aOR] = 8.44; area under the ROC curve [AUC-ROC] = 0.864; PLOS: aOR = 6.39; AUC-ROC = 0.859). The PNI, COUNT, and GNRI effectively predicted ICU stay and PLOS among surgical patients with EC and HNC.