Tsuchihashi Jin, Koya Shunji, Hirota Keisuke, Koga Noboru, Narao Hayato, Tomita Manabu, Kawaguchi Takumi, Hashida Ryuki, Nakano Dan, Tsutsumi Tsubasa, Yoshio Sachiyo, Matsuse Hiroo, Sanada Taku, Notsumata Kazuo, Torimura Takuji
Division of Rehabilitation, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Japan.
Division of Rehabilitation, Kurume University Hospital, Kurume 830-0011, Japan.
Cancers (Basel). 2021 Jan 7;13(2):194. doi: 10.3390/cancers13020194.
Frailty including physical inactivity is associated with the survival of patients with hepatocellular carcinoma (HCC). We aimed to investigate the effects of in-hospital exercise on frailty in patients with HCC. This was a multi-center observational study. Patients with HCC were classified into exercise ( = 114) and non-exercise ( = 67) groups. The exercise group was treated with a mixture of aerobic and resistance exercises (20-40 min/day, median four days). Frailty was assessed using the liver frailty index (LFI). Factors for changes in LFI were examined by multivariate and decision-tree analyses. The factors were also examined after propensity score matching. During hospitalization, LFI was significantly improved in the exercise group compared to the non-exercise group (ΔLFI -0.17 vs. -0.02, = 0.0119). In multivariate analysis, exercise (odds ratio (OR) 2.38, 95% confidence interval (CI) 1.240-4.570, = 0.0091) and females (OR 2.09; 95%CI, 1.062-4.109; = 0.0328) were identified as independent factors for the improvement of LFI. In the decision-tree analysis, exercise was identified as an initial classifier associated with the improvement of LFI. Similar findings were also seen in the propensity score matching analyses. We demonstrated that in-hospital exercise improved frailty in patients with HCC. Thus, in-hospital exercise may be beneficial for improving physical function in patients with HCC.
包括身体活动不足在内的衰弱与肝细胞癌（HCC）患者的生存相关。我们旨在研究院内运动对HCC患者衰弱的影响。这是一项多中心观察性研究。HCC患者被分为运动组（n = 114）和非运动组（n = 67）。运动组接受有氧运动和抗阻运动相结合的治疗（每天20 - 40分钟，中位时间为四天）。使用肝脏衰弱指数（LFI）评估衰弱情况。通过多变量和决策树分析检查LFI变化的因素。在倾向得分匹配后也对这些因素进行了检查。住院期间，与非运动组相比，运动组的LFI显著改善（LFI变化值为 - 0.17 vs. - 0.02，P = 0.0119）。在多变量分析中，运动（优势比（OR）为2.38，95%置信区间（CI）为1.240 - 4.570，P = 0.0091）和女性（OR为2.09；95%CI为1.062 - 4.109；P = 0.0328）被确定为LFI改善的独立因素。在决策树分析中，运动被确定为与LFI改善相关的初始分类因素。在倾向得分匹配分析中也观察到了类似的结果。我们证明了院内运动改善了HCC患者的衰弱状况。因此，院内运动可能有利于改善HCC患者的身体功能。
