Empirical Assessment of Nutritional Status and Surgical Outcomes in Head and Neck Cancer Patients in South West Nigeria

Malnutrition is highly prevalent among head and neck cancer patients due to anatomical impairment of food intake and the catabolic effects of malignancy, yet its quantified impact on surgical outcomes in Nigerian patients has not been empirically studied. This empirical study assesses preoperative nutritional status and its association with surgical outcomes in head and neck cancer patients managed at teaching hospitals in Ogun and Oyo states, South West Nigeria, from 2020 to 2023. A prospective cohort of 90 patients undergoing resection for head and neck malignancies was enrolled. Nutritional assessment included BMI, serum albumin, and the Subjective Global Assessment (SGA) tool. Surgical outcomes included SSI rates, wound dehiscence, anastomotic complications, length of stay, and 30-day mortality. Moderate or severe malnutrition was identified in 54% of patients. Malnourished patients had significantly higher SSI rates (OR 3.1), longer hospital stays (mean 5.3 additional days), and higher 30-day mortality (OR 2.8). Serum albumin below 30 g/L was the strongest independent predictor of complications. Preoperative nutritional supplementation was prescribed in only 28% of at-risk patients. The study recommends universal preoperative nutritional screening, a mandatory nutrition optimization window before elective head and neck surgery, and dietitian-integrated surgical oncology teams in South West Nigeria. Keywords: head and neck cancer, malnutrition, surgical outcomes, serum albumin, South West Nigeria