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营养风险是结直肠癌手术术后死亡率和发病率的临床预测指标。

Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer.

作者信息

Schwegler I, von Holzen A, Gutzwiller J-P, Schlumpf R, Mühlebach S, Stanga Z

机构信息

Department of Surgery, Berne University Hospital and University of Berne, Berne, Switzerland.

出版信息

Br J Surg. 2010 Jan;97(1):92-7. doi: 10.1002/bjs.6805.

Abstract

BACKGROUND

This study investigated whether nutritional risk scores applied at hospital admission predict mortality and complications after colorectal cancer surgery.

METHODS

Some 186 patients were studied prospectively. Clinical details, Reilly's Nutrition Risk Score (NRS) and Nutritional Risk Screening 2002 (NRS-2002) score, tumour stage and surgical procedure were recorded.

RESULTS

The prevalence of patients at nutritional risk was 31.7 per cent according to Reilly's NRS and 39.3 per cent based on the NRS-2002. Such patients had a higher mortality rate than those not at risk according to Reilly's NRS (8 versus 1.6 per cent; P = 0.033), but not the NRS-2002 (7 versus 1.8 per cent; P = 0.085). Based on the NRS-2002, there was a significant difference in postoperative complication rate between patients at nutritional risk and those not at risk (62 versus 39.8 per cent; P = 0.004) but not if Reilly's NRS was used (58 versus 44.1 per cent; P = 0.086). Nutritional risk was identified as an independent predictor of postoperative complications (odds ratio 2.79; P = 0.002).

CONCLUSION

Nutritional risk screening may be able to predict mortality and morbidity after surgery for colorectal cancer. However, the diverse results reflect either the imprecision of the tests or the small sample size.

摘要

背景

本研究调查了入院时应用的营养风险评分是否可预测结直肠癌手术后的死亡率和并发症。

方法

前瞻性研究了约186例患者。记录临床细节、赖利营养风险评分(NRS)和营养风险筛查2002(NRS - 2002)评分、肿瘤分期和手术方式。

结果

根据赖利的NRS,营养风险患者的患病率为31.7%,基于NRS - 2002则为39.3%。根据赖利的NRS,此类患者的死亡率高于无风险患者(8%对1.6%;P = 0.033),但NRS - 2002未显示此差异(7%对1.8%;P = 0.085)。基于NRS - 2002,营养风险患者与无风险患者的术后并发症发生率存在显著差异(62%对39.8%;P = 0.004),但使用赖利的NRS时未显示此差异(58%对44.1%;P = 0.086)。营养风险被确定为术后并发症的独立预测因素(比值比2.79;P = 0.002)。

结论

营养风险筛查或许能够预测结直肠癌手术后的死亡率和发病率。然而,结果的多样性反映了检测的不精确性或样本量较小。

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