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择期手术前妇科癌症患者临床营养不良预测模型:一项横断面研究。

Clinical malnutrition predictive model among gynecologic cancer patients prior to elective operation: A cross-sectional study.

作者信息

Ho Chiou Yi, Ibrahim Zuriati, Abu Zaid Zalina, Mat Daud Zulfitri 'Azuan, Md Yusop Nor Baizura

机构信息

Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia; Dietetics and Food Service Department, National Cancer Institute, 4, Jalan P7, Presint 7, 62250, Putrajaya, Ministry of Health, Malaysia.

Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia.

出版信息

Clin Nutr. 2021 Jun;40(6):4373-4379. doi: 10.1016/j.clnu.2021.01.008. Epub 2021 Jan 12.

Abstract

BACKGROUND

Malnutrition is common among cancer patients regardless of stage of cancer. Given the strong association between malnutrition with prolonged hospitalization, delayed recovery and even higher post-operative complications among gynaecologic cancer (GC) patients, it is important to understand its predictive factors. The current study aimed to determine malnutrition predictors among GC patients before elective operation.

METHOD

A cross-sectional study was conducted among surgical GC patients who were admitted for elective surgery. Data on socio-demographic characteristics, clinical status (diagnosis, the staging of cancer, comorbidities and family history on cancer), anthropometric measures [ Body Mass Index (BMI), weight changes, the percentage of weight loss past one month, muscle mass, fat mass, fat-free mass and mid-upper arm circumference (MUAC)], biochemical profiles [C-reactive protein, albumin and C-reactive protein (CRP) to albumin ratio (CAR)], handgrip strength, total daily energy and protein intake, and malnutrition status [scored Patient Generated-Subjective Global Assessment (PG-SGA)] were assessed during admission.

RESULTS

Study recruited 124 participants and 57.2% (n = 71) were malnourished. Mean for age, weight changes past one month, handgrip strength, total daily energy and protein intake, PG-SGA score and CAR of participants were 49.9 ± 12.5 years, -4.9 ± 7.2%, 15.6 ± 6.2 kg, 25±7 kcal/kg/day, 1.0 ± 0.3 g/kg/day, 6.5 ± 5.4 and 0.7 ± 1.9, respectively. Multiple linear regression test revealed that the percentage of weight loss past one month, haemoglobin, CRP and handgrip strength were the significant predictors of malnutrition.

CONCLUSION

Malnutrition is common among GC patient even before elective operation. The early malnutrition screening following with proper nutritional intervention is crucial to optimize nutritional status among GC patients before elective operation.

摘要

背景

无论癌症处于何种阶段,营养不良在癌症患者中都很常见。鉴于营养不良与妇科癌症(GC)患者住院时间延长、恢复延迟甚至术后并发症增加之间存在密切关联,了解其预测因素很重要。本研究旨在确定择期手术前GC患者的营养不良预测因素。

方法

对因择期手术入院的GC手术患者进行了一项横断面研究。收集了社会人口学特征、临床状况(诊断、癌症分期、合并症和癌症家族史)、人体测量指标[体重指数(BMI)、体重变化、过去一个月体重减轻百分比、肌肉量、脂肪量、去脂体重和上臂中部周长(MUAC)]、生化指标[C反应蛋白、白蛋白以及C反应蛋白(CRP)与白蛋白比值(CAR)]、握力、每日总能量和蛋白质摄入量以及营养不良状况[采用患者主观全面评定法(PG-SGA)评分]等数据。

结果

该研究招募了124名参与者,其中57.2%(n = 71)存在营养不良。参与者的平均年龄、过去一个月的体重变化、握力、每日总能量和蛋白质摄入量、PG-SGA评分以及CAR分别为49.9±12.5岁、-4.9±7.2%、15.6±6.2千克、25±7千卡/千克/天、1.0±0.3克/千克/天、6.5±5.4以及0.7±1.9。多元线性回归分析显示,过去一个月的体重减轻百分比、血红蛋白、CRP和握力是营养不良的显著预测因素。

结论

即使在择期手术前,营养不良在GC患者中也很常见。在择期手术前,早期进行营养不良筛查并给予适当的营养干预对于优化GC患者的营养状况至关重要。

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