Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan; Department of Nutrition, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
HPB (Oxford). 2019 Sep;21(9):1150-1155. doi: 10.1016/j.hpb.2019.01.003. Epub 2019 Feb 11.
The aim of this study was to analyze the nutritional risk factors for postoperative complications following hepatic resection for hepatocellular carcinoma (HCC).
The preoperative nutritional status of patients with HCC who underwent hepatic resection was evaluated using the scored Patient-Generated Subjective Global Assessment (PG-SGA). The perioperative variables were compared between well-nourished and malnourished patients. Regression analysis was employed to identify the risk factors for postoperative complications.
The overall operative mortality and morbidity of 287 patients who underwent resection for HCC were 1.7% and 44.3%, respectively. Upon admission, 96 (33.4%) study participants were malnourished, which was associated with a significantly higher PG-SGA score (P < 0.001), higher frequency of comorbidity (P < 0.001), more postoperative complications (P < 0.001) and a longer length of hospital stay (P < 0.001). In addition, major complications (Clavien-Dindo classification ≥ IIIa) occurred significantly more frequently in the malnourished group (P < 0.01). Age ≥70 years (risk ratio [RR] = 2.50, P = 0.008) and PG-SGA score ≥ 4 ([RR] = 9.85, P < 0.001) were significant risk factors for postoperative complications.
The PG-SGA score is an effective tool for predicting postoperative complications in patients with HCC following hepatic resection.
本研究旨在分析肝细胞癌（HCC）肝切除术后并发症的营养风险因素。
采用评分患者主观整体评估（PG-SGA）评估 HCC 行肝切除术患者的术前营养状况。比较营养良好和营养不良患者的围手术期变量。采用回归分析确定术后并发症的危险因素。
287 例行 HCC 切除术患者的总手术死亡率和发病率分别为 1.7%和 44.3%。入院时，96 名（33.4%）研究参与者存在营养不良，这与更高的 PG-SGA 评分（P<0.001）、更高的合并症频率（P<0.001）、更多的术后并发症（P<0.001）和更长的住院时间（P<0.001）相关。此外，营养不良组发生重大并发症（Clavien-Dindo 分级≥IIIa）的频率明显更高（P<0.01）。年龄≥70 岁（风险比 [RR] = 2.50，P = 0.008）和 PG-SGA 评分≥4（[RR] = 9.85，P<0.001）是术后并发症的显著危险因素。
PG-SGA 评分是预测 HCC 肝切除术后患者术后并发症的有效工具。
