Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.
J Gastrointest Surg. 2019 Sep;23(9):1810-1816. doi: 10.1007/s11605-018-3993-5. Epub 2018 Oct 8.
The aims of this study were to clarify the relationship of gait speed, hand grip strength, and skeletal muscle mass with complications after hepatic resection and to identify risk factors for complications in patients who underwent hepatic resection.
We evaluated the risk factors for complications after hepatic resection in 154 consecutive patients. Preoperative factors included gait speed, hand grip strength, and skeletal muscle mass. The gait speed and hand grip strength of patients were measured by physical therapists, and skeletal muscle mass was measured by computed tomography. Multivariate logistic regression analyses using preoperative factors were performed to assess predictors of the development of complications after hepatic resection.
Thirty-three patients (21.4%) developed complications after hepatic resection. These patients had a significantly lower serum albumin level (p = 0.015), slower gait speed (p = 0.007), higher rate of hepatic resection ≥ 2 Couinaud segments (p = 0.014), and lower rate of laparoscopic hepatic resection (p = 0.017) than patients without complications. Multivariate analysis revealed that a gait speed ≤ 1.10 m/s and a serum albumin level of ≤ 4.0 g/dl were independent risk factors for complications after hepatic resection.
Slow gait speed and low serum albumin level are significant risk factors for complications after hepatic resection. These data will be helpful for perioperative patient management.
本研究旨在阐明步态速度、握力和骨骼肌质量与肝切除术后并发症的关系,并确定行肝切除术患者并发症的危险因素。
我们评估了 154 例连续患者肝切除术后并发症的危险因素。术前因素包括步态速度、握力和骨骼肌质量。由物理治疗师测量患者的步态速度和握力,通过计算机断层扫描测量骨骼肌质量。使用术前因素进行多变量逻辑回归分析,以评估肝切除术后并发症发展的预测因素。
33 例(21.4%)患者在肝切除术后发生并发症。这些患者的血清白蛋白水平显著较低(p = 0.015),步态速度较慢(p = 0.007),肝切除≥2 Couinaud 段的比例较高(p = 0.014),腹腔镜肝切除术的比例较低(p = 0.017)。多变量分析显示,步态速度≤1.10 m/s 和血清白蛋白水平≤4.0 g/dl 是肝切除术后并发症的独立危险因素。
缓慢的步态速度和低血清白蛋白水平是肝切除术后并发症的显著危险因素。这些数据将有助于围手术期患者管理。