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营养状况对肺移植临床结局的影响。

The effect of nutritional status on clinical outcome in lung transplantation.

作者信息

Wang Weixiang, Chen Yongchun, Yang Tingting, Wang Wen, Guan Ke, Yang Yang, Wang Ling

机构信息

Department of nutrition, Department of Thoracic Surgery, Lung Transplant Center, Affiliated Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.

Faculty of Medicine, Macau University of Science and Technology, Macau, China. Email:

出版信息

Asia Pac J Clin Nutr. 2022;31(4):636-641. doi: 10.6133/apjcn.202212_31(4).0007.

Abstract

BACKGROUND AND OBJECTIVES

Nutritional status greatly impacts the clinical outcome of the patients receiving lung transplantation. The objective of this study was to evaluate the effect of nutritional status on the clinical outcome in lung transplant recipients.

METHODS AND STUDY DESIGN

A single-center retrospective study was conducted including 73 patients received lung transplantation from December 2015 to April 2022 in the Affiliated Henan Provincial People's Hospital of Zhengzhou University. Data were collected from the hospital information system. The records of BMI, malnutrition defined by the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria, hemoglobin and plasma albumin before operation were accessed. The primary outcome assessed was survival or mortality represented by Kaplan-Meier survival curves; the log-rank test and multivariate Cox proportional hazards regression were used to evaluate the influence of each factor on survival.

RESULTS

Kaplan-Meier survival analysis showed that malnutrition, hemoglobin and plasma albumin were predictors of survival in lung transplantation (Log Rank p<0.05). Multivariate Cox regression showed that pre-operative hemoglobin <130 g/L (HR 2.532, p=0.036) and plasma albumin <35 g/L (HR 2.723, p=0.016) were associated with the decreased survival rate.

CONCLUSIONS

Preoperative anemia and hypoalbuminemia increase the mortality risk of the lung transplantation patients. Pre-operative nutrition support, therefore, is likely to be critical for improving clinical outcome in patients undergoing lung transplantation.

摘要

背景与目的

营养状况对接受肺移植患者的临床结局有重大影响。本研究的目的是评估营养状况对肺移植受者临床结局的影响。

方法与研究设计

进行了一项单中心回顾性研究,纳入了2015年12月至2022年4月在郑州大学附属河南省人民医院接受肺移植的73例患者。数据从医院信息系统收集。获取术前体重指数、根据全球营养不良领导倡议(GLIM)诊断标准定义的营养不良、血红蛋白和血浆白蛋白记录。评估的主要结局是以Kaplan-Meier生存曲线表示的生存或死亡;采用对数秩检验和多变量Cox比例风险回归来评估各因素对生存的影响。

结果

Kaplan-Meier生存分析表明,营养不良、血红蛋白和血浆白蛋白是肺移植生存的预测因素(对数秩p<0.05)。多变量Cox回归显示,术前血红蛋白<130 g/L(HR 2.532,p=0.036)和血浆白蛋白<35 g/L(HR 2.723,p=0.016)与生存率降低相关。

结论

术前贫血和低白蛋白血症增加了肺移植患者的死亡风险。因此,术前营养支持可能对改善肺移植患者的临床结局至关重要。

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