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肌肉质量低和 Charlson 合并症指数是老年胃肠道肿瘤患者短期术后预后的危险因素:一项横断面研究。

Low muscle mass and Charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor: a cross-sectional study.

机构信息

Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.

Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.

出版信息

BMC Geriatr. 2021 Dec 23;21(1):730. doi: 10.1186/s12877-021-02683-z.

Abstract

BACKGROUND

Sarcopenia is one of the most frequent syndromes in older adults and one of its main characteristics is low muscle mass. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of low muscle mass in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between low muscle mass and short-term postoperative prognosis.

METHOD

A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate low muscle mass. Short-term postoperative complications and length of stay were considered as short-term outcomes of this study.

RESULTS

Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of low muscle mass, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of low muscle mass. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Low muscle mass and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in older adults with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay.

CONCLUSIONS

Low muscle mass and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.

摘要

背景

肌肉减少症是老年人最常见的综合征之一,其主要特征之一是肌肉量低。胃肠道肿瘤是一种发病率较高的恶性疾病。本研究旨在探讨老年胃肠道肿瘤患者低肌肉量的危险因素、胃肠道肿瘤切除术后的预后指标和短期结局,并探讨低肌肉量与短期术后预后的关系。

方法

本研究共纳入 2019 年接受根治性切除术的 247 例老年胃肠道肿瘤患者。使用计算机断层扫描(CT)的 L3 切片图像计算相关指标,以评估低肌肉量。短期术后并发症和住院时间被视为本研究的短期结局。

结果

高龄、较高的体质指数(BMI)、较低的血红蛋白、有腹部手术史和较高的内脏脂肪指数(VFI)是低肌肉量的危险因素,而较高的 BMI 和较低的皮下脂肪指数(SFI)是低肌肉量的保护因素。进一步的多变量逻辑回归分析表明,有腹部手术史、高龄和较低的 BMI 是低肌肉量的独立危险因素。低肌肉量和较高的 Charlson 合并症指数是老年胃肠道肿瘤患者短期术后并发症的独立危险因素。较高的 Charlson 合并症指数导致住院时间延长。

结论

低肌肉量和较高的 Charlson 合并症指数预示着接受胃肠道肿瘤切除术的老年患者短期预后不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dae/8705191/c5a3cfd907e7/12877_2021_2683_Fig1_HTML.jpg

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