Nutritional status was evaluated in 50 consecutive patients with advanced squamous cell carcinoma of the head and neck. Using a linear equation developed by Busby, the prognostic nutritional index (PNI) was calculated from the serum albumin, triceps skin-fold thickness, serum transferrin, and delayed hypersensitivity reaction. The treatment plan was determined by the patient's attending physician and complications were retrospectively evaluated. The patients were divided into three groups by the value of the PNI. The complication rate was not significantly higher in patients with moderate malnutrition (PNI between 20% and 39%). However, with severe malnutrition (PNI greater than 39%), the incidence of iatrogenic complications was prohibitive and 12 of 14 patients were dead within 6 months. We conclude that the PNI is a simple, objective measure of nutritional status that will identify patients at high risk for therapy-related complications and early death.
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