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衰弱合并营养风险评分预测老年胃肠道恶性肿瘤患者术后并发症。

Frailty combined with nutritional risk score in predicting postoperative complications of elderly patients with gastrointestinal malignancies.

机构信息

Binzhou Medical University, 256603, Binzhou, China.

Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, 256603, Binzhou, China.

出版信息

Asian J Surg. 2023 Oct;46(10):4240-4244. doi: 10.1016/j.asjsur.2023.01.003. Epub 2023 Jan 16.

Abstract

OBJECTIVE

Exploring the predictive power of frailty combined with nutritional risk on postoperative complications in elderly gastrointestinal malignancies patients.

METHODS

Elderly patients who underwent gastrointestinal cancer surgery at Gastrointestinal Surgery Department of the Affiliated Hospital of Binzhou Medical University from August 2021 to June 2022 were selected as the research subjects. The patients' frailty and nutritional status were assessed using the Fried Frailty Scale and the NRS2002 Nutritional Risk Scale within 24 h of admission. Observing and recording the diagnosis and treatment of postoperative complications during the hospitalization.

RESULTS

202 patients were enrolled, including 119 patients (58.91%) with nutritional risk and 89 patients (44.06%) with frailty. Frailty was an independent risk factor for postoperative complications [OR = 5.904, 95%CI (3.103, 11.233)]. The AUC value of frailty assessment was 0.780, which was greater than the AUC value of NRS2002 score of 0.705 (P < 0.01). The AUC value of frailty assessment combined with NRS-2002 score was 0.844, which was significantly higher than that alone (P < 0.01).

CONCLUSIONS

The ability of frailty to predict postoperative complications is better than the NRS-2002 score. Frailty combined with nutritional risk assessment can increase the predictive power of postoperative complications in elderly gastrointestinal malignancies patients.

摘要

目的

探讨衰弱与营养风险联合对老年胃肠道恶性肿瘤患者术后并发症的预测能力。

方法

选取 2021 年 8 月至 2022 年 6 月滨州医学院附属医院胃肠外科收治的老年胃肠道恶性肿瘤手术患者为研究对象。患者入院 24 h 内采用 Fried 衰弱量表和 NRS2002 营养风险量表评估其衰弱和营养状况,观察并记录住院期间术后并发症的诊治情况。

结果

共纳入 202 例患者,其中营养风险 119 例(58.91%),衰弱 89 例(44.06%)。衰弱是术后并发症的独立危险因素[OR=5.904,95%CI(3.103,11.233)]。衰弱评估的 AUC 值为 0.780,大于 NRS2002 评分的 AUC 值 0.705(P<0.01)。衰弱评估联合 NRS-2002 评分的 AUC 值为 0.844,明显高于单独评估(P<0.01)。

结论

衰弱预测术后并发症的能力优于 NRS-2002 评分。衰弱联合营养风险评估可提高老年胃肠道恶性肿瘤患者术后并发症的预测能力。

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