Matsui Ryota, Inaki Noriyuki, Tsuji Toshikatsu, Momosaki Ryo, Fukunaga Tetsu
Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan.
Department of Upper Gastrointestinal Surgery, Juntendo University Hospital, Tokyo 113-8431, Japan.
J Clin Med. 2022 Nov 30;11(23):7129. doi: 10.3390/jcm11237129.
In this study, we investigated whether preoperative low-handgrip strength (HGS) defined by the Asian working group for sarcopenia could be a predictor of postoperative outcomes in patients with gastric cancer. A total of 327 patients who underwent radical gastrectomy for c-stage I-III primary gastric cancer with pre-operative HGS records were included. The cut-off values of HGS were defined as 28 kg for males and 18 kg for females, with values below and above the cut-off defined as low-HGS and high-HGS, respectively. The primary outcome was infectious complications. We compared the postoperative outcomes of the groups after adjusting for the background using propensity score matching. Of the 327 patients, 246 (75.2%) and 81 (24.8%) were in the high and low-HGS groups, respectively. After adjusting for background, there were 57 patients in both groups. After matching, the low-HGS group had significantly more infectious complications (17.5% vs. 1.8%, = 0.008). Multivariate analysis of infectious complications in the low-HGS group demonstrated chronic kidney disease and diabetes as independent risk factors (odds ratio 4.390, 95% confidence interval 1.120-17.20, = 0.034). Preoperative low-HGS according to the Asian criteria was associated with infectious complications after gastrectomy. Chronic kidney disease and diabetes were independent risk factors for infectious complications among patients with low-HGS.
在本研究中，我们调查了亚洲肌少症工作组定义的术前低握力（HGS）是否可作为胃癌患者术后结局的预测指标。总共纳入了327例接受根治性胃切除术治疗I-III期原发性胃癌且有术前HGS记录的患者。HGS的截断值定义为男性28kg，女性18kg，低于和高于截断值的值分别定义为低HGS和高HGS。主要结局为感染性并发症。我们使用倾向得分匹配法对背景因素进行校正后比较了两组的术后结局。在这327例患者中，高HGS组和低HGS组分别有246例（75.2%）和81例（24.8%）。校正背景因素后，两组各有57例患者。匹配后，低HGS组的感染性并发症明显更多（17.5%对1.8%，P = 0.008）。对低HGS组感染性并发症的多因素分析显示，慢性肾脏病和糖尿病是独立危险因素（比值比4.390，95%置信区间1.120 - 17.20，P = 0.034）。根据亚洲标准，术前低HGS与胃切除术后的感染性并发症相关。慢性肾脏病和糖尿病是低HGS患者感染性并发症的独立危险因素。
