Kim Min-Yu, Kim So Yeon, Shin Hye Jung, Kweon Ki Hong, Park Jooeun, Kim Na Young
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Cancers (Basel). 2023 Sep 27;15(19):4753. doi: 10.3390/cancers15194753.
We aimed to investigate the association between sarcopenia and incidence of pneumonia after endoscopic submucosal dissection (ESD) in patients aged ≥65 years. Patients with ( = 1571) and without sarcopenia ( = 1718) who underwent ESD for gastric neoplasm were included. Propensity score matching (PSM) was performed between the groups ( = 785) at a 1:1 ratio. The primary endpoint was the effect of sarcopenia on the incidence of pneumonia after ESD. Among the included patients, 2.2% ( = 71) developed pneumonia after ESD. After PSM, the incidence rate of pneumonia was significantly higher in patients with sarcopenia than that in patients without sarcopenia ( = 0.024). Sarcopenia and age ≥73 years were significantly associated with the incidence of pneumonia (sarcopenia and age <73 years, odd ratio (OR) = 1.22 [95% confidence interval (CI): 0.46-3.22]; sarcopenia and age ≥73 years, OR = 3.92 [95% CI: 1.79-8.74]). Patients with sarcopenia had an increased risk of developing pneumonia after ESD, even after adjusting for other factors, resulting in a higher incidence of leukocytosis and a longer duration of post-ESD hospitalization. The combination of sarcopenia and age ≥73 years could be an effective predictive factor for screening high-risk groups for pneumonia after ESD.
我们旨在调查65岁及以上患者内镜下黏膜剥离术（ESD）后肌肉减少症与肺炎发生率之间的关联。纳入了因胃肿瘤接受ESD治疗的有肌肉减少症（n = 1571）和无肌肉减少症（n = 1718）的患者。两组（n = 785）之间进行了1:1比例的倾向评分匹配（PSM）。主要终点是肌肉减少症对ESD后肺炎发生率的影响。在所纳入的患者中，2.2%（n = 71）在ESD后发生了肺炎。PSM后，有肌肉减少症的患者肺炎发生率显著高于无肌肉减少症的患者（P = 0.024）。肌肉减少症和年龄≥73岁与肺炎发生率显著相关（肌肉减少症且年龄<73岁，比值比（OR）= 1.22 [95%置信区间（CI）：0.46 - 3.22]；肌肉减少症且年龄≥73岁，OR = 3.92 [95% CI：1.79 - 8.74]）。即使在调整其他因素后，有肌肉减少症的患者在ESD后发生肺炎的风险增加，导致白细胞增多症发生率更高且ESD后住院时间更长。肌肉减少症与年龄≥73岁的组合可能是筛查ESD后肺炎高危人群的有效预测因素。
