Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Nutrition. 2019 May;61:61-66. doi: 10.1016/j.nut.2018.10.025. Epub 2018 Oct 24.
The aim of this study was to investigate the prevalence of sarcopenia in patients without nutritional risk and the association between sarcopenia and postoperative outcomes after radical gastrectomy in these patients.
We conducted a study of non-nutritional risk patients with gastric cancer who underwent gastrectomy from August 2014 to December 2017 in two centers. Nutritional Risk Screening 2002 (NRS 2002) was used to evaluate the nutritional risk. Patients who with NRS 2002 score <3 were classified as having no nutritional risk and were included in the study. Demographic and perioperative data were gathered. Sarcopenia was diagnosed based on the European Working Group on Sarcopenia in Older People criteria. Univariate and multivariate analysis were performed to determine the association between preoperative risk factors and postoperative complications.
In all, 545 patients were included, in which the prevalence of sarcopenia and postoperative complications was 7.3% and 21.1%, respectively. Sarcopenia was significantly associated with higher age, lower body mass index, lower handgrip strength, lower usual walking speed, longer postoperative hospital length of stay, and higher costs. Multivariate analysis of prognostic factors revealed that sarcopenia was an independent predictor (odds ratio, 2.330; 95% confidence interval, 1.132-4.796; P = 0.022] for postoperative complications. Male sex, diabetes, and preoperative anemia also were risk factors for postoperative complications.
Sarcopenia was a significant independent risk factor for postoperative complications after gastrectomy in patients without nutritional risk. Preoperative assessment and management of sarcopenia should be helpful for improving clinical outcomes for patients without nutritional risk.
本研究旨在探讨无营养风险患者中肌少症的患病率，以及肌少症与这些患者根治性胃切除术后术后结局的关系。
我们对 2014 年 8 月至 2017 年 12 月在两个中心接受胃切除术的无营养风险胃癌患者进行了一项研究。使用营养风险筛查 2002（NRS 2002）评估营养风险。NRS 2002 评分<3 的患者被归类为无营养风险，并纳入研究。收集了人口统计学和围手术期数据。根据欧洲老年人肌少症工作组的标准诊断肌少症。进行单因素和多因素分析，以确定术前危险因素与术后并发症之间的关系。
共纳入 545 例患者，肌少症和术后并发症的患病率分别为 7.3%和 21.1%。肌少症与较高的年龄、较低的体重指数、较低的握力、较低的通常步行速度、较长的术后住院时间和较高的费用显著相关。预后因素的多因素分析显示，肌少症是术后并发症的独立预测因素（比值比，2.330；95%置信区间，1.132-4.796；P=0.022）。男性、糖尿病和术前贫血也是术后并发症的危险因素。
肌少症是无营养风险患者根治性胃切除术后术后并发症的一个显著独立危险因素。术前评估和肌少症管理有助于改善无营养风险患者的临床结局。
