Wang Lijuan, Li Pengxue, Hu Yifu, Cheng Bo, Ding Lili, Li Lei, Song Jinghai, Wei Junmin, Xu Jingyong
Department of Clinical Nutrition, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of General Surgery, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Nutr. 2023 Feb 21;10:1135854. doi: 10.3389/fnut.2023.1135854. eCollection 2023.
To analyze the correlation between preoperative nutritional status, frailty, sarcopenia, body composition, and anthropometry in geriatric inpatients undergoing major pancreatic and biliary surgery.
This is a cross-sectional study of the database from December 2020 to September 2022 in the department of hepatopancreatobiliary surgery, Beijing Hospital. Basal data, anthropometry, and body composition were recorded. NRS 2002, GLIM, FFP 2001, and AWGS 2019 criteria were performed. The incidence, overlap, and correlation of malnutrition, frailty, sarcopenia, and other nutrition-related variables were investigated. Group comparisons were implemented by stratification of age and malignancy. The present study adhered to the STROBE guidelines for cross-sectional study.
A total of 140 consecutive cases were included. The prevalence of nutritional risk, malnutrition, frailty, and sarcopenia was 70.0, 67.1, 20.7, and 36.4%, respectively. The overlaps of malnutrition with sarcopenia, malnutrition with frailty, and sarcopenia with frailty were 36.4, 19.3, and 15.0%. There is a positive correlation between every two of the four diagnostic tools, and all six -values were below 0.002. Albumin, prealbumin, CC, GS, 6MTW, ASMI, and FFMI showed a significantly negative correlation with the diagnoses of the four tools. Participants with frailty or sarcopenia were significantly more likely to suffer from malnutrition than their control groups with a 5.037 and 3.267 times higher risk, respectively (for frailty, 95% CI: 1.715-14.794, = 0.003 and for sarcopenia, 95% CI: 2.151-4.963, <0.001). Summarizing from stratification analysis, most body composition and function variables were worsen in the ≥70 years group than in the younger group, and malignant patients tended to experience more intake reduction and weight loss than the benign group, which affected the nutrition diagnosis.
Elderly inpatients undergoing major pancreatic and biliary surgery possessed high prevalence and overlap rates of malnutrition, frailty, and sarcopenia. Body composition and function deteriorated obviously with aging.
分析接受胰腺和胆道大手术的老年住院患者术前营养状况、衰弱、肌少症、身体成分和人体测量学之间的相关性。
这是一项对北京医院肝胆胰外科2020年12月至2022年9月数据库的横断面研究。记录基础数据、人体测量学和身体成分。采用NRS 2002、GLIM、FFP 2001和AWGS 2019标准。调查营养不良、衰弱、肌少症和其他营养相关变量的发生率、重叠情况及相关性。通过年龄和恶性肿瘤分层进行组间比较。本研究遵循横断面研究的STROBE指南。
共纳入140例连续病例。营养风险、营养不良、衰弱和肌少症的患病率分别为70.0%、67.1%、20.7%和36.4%。营养不良与肌少症、营养不良与衰弱、肌少症与衰弱的重叠率分别为36.4%、19.3%和15.0%。四种诊断工具两两之间呈正相关，所有六个P值均低于0.002。白蛋白、前白蛋白、CC、GS、6MTW、ASMI和FFMI与四种工具的诊断呈显著负相关。与对照组相比，衰弱或肌少症患者患营养不良的可能性显著更高，风险分别高5.037倍和3.267倍（衰弱患者，95%CI：1.715 - 14.794，P = 0.003；肌少症患者为95%CI：2.151 - 4.963，P<0.001）。分层分析总结，≥70岁组的大多数身体成分和功能变量比年轻组更差，恶性患者比良性组更容易出现摄入量减少和体重减轻，这影响了营养诊断。
接受胰腺和胆道大手术的老年住院患者营养不良、衰弱和肌少症的患病率及重叠率较高。身体成分和功能随年龄增长明显恶化。
