摘要
目的:分析肌少症性肥胖对胃癌手术病人临床结局的预测价值。方法:采用便利取样法,前瞻性选取2020年5~10月在南京医科大学第一附属医院普外胃外科拟行胃癌手术病人255例。入院24 h内收集病人一般资料、肌少症性肥胖诊断指标和营养风险筛查2002(NRS 2002);出院当天收集病人手术信息、TNM分期和院内临床结局指标(术后并发症、术后住院时间和住院费用);术后3个月收集病人院外临床结局指标(再入院和生存情况)。以临床结局指标为因变量,其余指标为自变量,分别建立回归模型,分析肌少症性肥胖对胃癌手术病人临床结局的预测价值。结果:本研究最终纳入250例病人,胃癌病人术前肌少症性肥胖的发生率为5.2%。多因素分析主要结果显示,术前存在肌少症性肥胖是胃癌病人发生术后并发症[OR=11.186(95%CI:1.916~65.316),P=0.007]、术后3个月内再入院[HR=3.390(95%CI:1.127~9.891),P=0.030]和术后3个月内死亡[HR=9.125(95%CI:1.515~54.969),P=0.016]的独立危险因素。结论:术前存在肌少症性肥胖可增加胃癌病人发生术后并发症、术后3个月内再入院和术后3个月内死亡的风险,此可为改善胃癌病人临床结局提供参考方向。
Objective:To analyze the predictive values of sarcopenic obesity on clinical outcomes of gastric cancer patients undergoing surgery.Methods:Using the convenience sampling method,a total of 255 patients who were scheduled to undergo gastric cancer surgery in the Department of Gastric Surgery,the First Affiliated Hospital with Nanjing Medical University were selected prospectively from May to October 2020.Patient general information,sarcopenic obesity diagnostic indicators and nutrition risk screening 2002(NRS 2002)were collected within 24 hours after admission.On the day of discharge,patient operation information,TNM stage and clinical outcomes in hospital(postoperative complications,hospitalization costs and postoperative hospital stay)were collected.Three months after discharge,clinical outcomes out of hospital(hospital readmissions and mortality)were collected.Regression models were established with clinical outcomes as dependent variables as well as the others as independent variables,analyzing the predictive values of sarcopenic obesity on clinical outcomes in gastric cancer patients undergoing surgery.Results:A total of 250 patients were included in this study.The incidence of sarcopenic obesity in preoperative gastric cancer patients was 5.2%.The main results of multivariate analysis showed that preoperative sarcopenic obesity was an independent factor for postoperative complications in gastric cancer patients[OR=11.186(95%CI:1.916~65.316),P=0.007],readmission within 3 months[HR=3.390(95%CI:1.127~9.891),P=0.030]and death within 3 months[HR=9.125(95%CI:1.515~54.969),P=0.016].Conclusion:Preoperative sarcopenic obesity can increase the risk of postoperative complications,readmission within 3 months,and death within 3 months in gastric cancer patients,which could provide a reference direction for improving the clinical outcomes in gastric cancer patients.
作者
陈丽
陆金玲
许勤
侯慧
胡洁蔓
徐皓
张殿彩
杨春静
CHEN Li;LU Jin-ling;XU Qin;HOU Hui;HU Jie-man;XU Hao;ZHANG Dian-cai;YANG Chun-jing(Department one of Gastric Surgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;School of Nursing,Nanjing Medical University,Nanjing 211166,Jiangsu,China;Department two of Gastric Surgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2023年第2期102-108,共7页
Parenteral & Enteral Nutrition
基金
国家自然科学基金面上项目(82073407)
关键词
胃癌
肌少症性肥胖
临床结局
预测价值
Gastric cancer
Sarcopenic obesity
Clinical outcomes
Predictive values
作者简介
陈丽,主任护师,主要从事胃癌病人的营养与代谢研究。E-mail:beijia73@163.com
