Nutritional Status in Patients with Medication-Related Osteonecrosis of the Jaw (MRONJ)

Nutrients

Alexander Egger¹  Andrea Griesmacher¹  SabrinaB. Neururer²  Emanuel Bruckmoser³  Alexander Höller⁴  Ute Pichler⁴  Johannes Laimer⁵  Raphael Engel⁵ 

[1] Central Institute for Medical and Chemical Laboratory Diagnosis, University Hospital Innsbruck, Medical University Innsbruck, A-6020 Innsbruck, Austria;Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH, A-6020 Innsbruck, Austria;Private Practice for Oral and Maxillofacial Surgery, A-5020 Salzburg, Austria;Service for Nutrition and Dietetics, University Hospital Innsbruck, Medical University Innsbruck, A-6020 Innsbruck, Austria;University Hospital for Craniomaxillofacial and Oral Surgery, Medical University Innsbruck, A-6020 Innsbruck, Austria;

关键词: medication-related osteonecrosis of the jaw;    MRONJ;    nutritional status;    malnutrition;    micronutrients;    macronutrients;   

DOI  :  10.3390/nu13051585

来源: DOAJ

【 摘 要 】

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe side effect of mostly antiresorptive drugs. The aim of this prospective clinical study was to evaluate the nutritional status in MRONJ patients scheduled for surgical treatment (intraoral soft tissue closure). The following parameters were evaluated: body weight, body height, BMI, nutritional risk index (NRI), bioelectric impedance analysis (BIA), vitamins A, B12, D3, E, K1, folic acid, iron, total protein, transferrin, ferritin, prealbumin, albumin, and zinc. All subjects were admitted to hospital four to five days before surgery and sip-fed with Nutritia Fortimel Compact Protein in addition to regular oral food intake. During surgery, a nasogastric tube was inserted and only removed on hospital discharge five days postoperatively. A total of 58 patients could be included. Half of the MRONJ patients were identified to be at risk for malnutrition. Deficiencies regarding protein levels were revealed, whereas hardly any relevant deficits of micronutrients were noted. The intraoral wound healing four weeks post-surgery was highly satisfactory with a low dehiscence rate of intraoral mucosal sites. Of all parameters analyzed, the dehiscence rate at the last follow-up four weeks post-surgery was significantly influenced by vitamin K, transferrin, and ferritin levels (p = 0.030, p = 0.004, and p = 0.023, respectively). In conclusion, perioperative dietary counselling and appropriate nutritional therapy are important supportive measures in MRONJ patients scheduled for intraoral soft tissue closure.

【 授权许可】

Unknown