Tian Qiuju, Qin Liyuan, Zhu Weiyi, Xiong Shaojie, Wu Beiwen
Nursing college, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Nursing Department, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, China.
PeerJ. 2020 Jul 10;8:e9390. doi: 10.7717/peerj.9390. eCollection 2020.
The study aimed to explore factors contributing to body weight change over time in gastric cancer patients after gastrectomy, in order to find risk factors to implement nutritional intervention beforehand.
A cohort of gastric cancer patients who were treated with gastrectomy from January to March 2019 at a university affiliated hospital in Shanghai were consecutively identified in this study. Demographics, disease related information, nutrition knowledge, attitude, and practice score were collected before gastrectomy. In addition, body weight before surgery (T0), body weight at one month (T1), two months (T2), and three months (T3) after gastrectomy were recorded. Generalized estimation equation was used to describe body weight change and analyze factors contributing to body weight change after surgery.
There were 49 patients recruited in the study. Patient body weight decreased by 9.2% at T1 (Wald = 271.173, <0.001), 11.0% at T2 (Wald = 277.267, <0.001), and 11.4% at T3 compared to baseline at T0 (Wald = 284.076, <0.001). The results of GEE for multivariable analysis showed that surgery type (Wald = 6.027, = 0.014) and preoperative BMI (Wald = 12.662, = 0.005) were contributing factors of body weight change. Compared with distal gastrectomy patients, total gastrectomy patients experienced greater body weight loss (β = 2.8%, = 0.014). Compared with patients with BMI&; 18.5 kg/m, patients with BMI ≥ 25 kg/mexperienced greater body weight loss (β = 4.5% = 0.026).
Gastric cancer patients experienced significant weight loss during 3 months after gastrectomy. Total gastrectomy and BMI ≥ 25 kg/mwere risk factors to postoperative body weight loss for GC patients. The results suggested hinted that clinician should pay attention to postoperative nutrition status of patient undergoing total gastrectomy and obesity patients.
本研究旨在探讨胃癌患者胃切除术后体重随时间变化的影响因素，以寻找风险因素，提前实施营养干预。
本研究连续纳入了2019年1月至3月在上海某大学附属医院接受胃切除术的一组胃癌患者。在胃切除术前收集患者的人口统计学信息、疾病相关信息、营养知识、态度和实践得分。此外，记录手术前（T0）、胃切除术后1个月（T1）、2个月（T2）和3个月（T3）的体重。采用广义估计方程描述体重变化，并分析术后体重变化的影响因素。
本研究共纳入49例患者。与T0时的基线相比，患者体重在T1时下降了9.2%（Wald = 271.173，P < 0.001），在T2时下降了11.0%（Wald = 277.267，P < 0.001），在T3时下降了11.4%（Wald = 284.076，P < 0.001）。多变量分析的广义估计方程结果显示，手术类型（Wald = 6.027，P = 0.014）和术前BMI（Wald = 12.662，P = 0.005）是体重变化的影响因素。与远端胃切除术患者相比，全胃切除术患者体重下降幅度更大（β = 2.8%，P = 0.014）。与BMI＜18.5 kg/m²的患者相比，BMI≥25 kg/m²的患者体重下降幅度更大（β = 4.5%，P = 0.026）。
胃癌患者在胃切除术后3个月内体重显著下降。全胃切除术和BMI≥25 kg/m²是胃癌患者术后体重下降的风险因素。研究结果提示临床医生应关注接受全胃切除术患者和肥胖患者的术后营养状况。
