Shen Ningzhe, Wen Jian, Chen Chenbin, Chen Xiaodong, Zhang Weiteng, Garijo Paula Domínguez, Wei Matthew Yuan-Kun, Chen Wenjing, Xue Xiangyang, Sun Xiangwei
Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Wenzhou Collaborative Innovation Center of Gastrointestinal Cancer in Basic Research and Precision Medicine, Wenzhou Key Laboratory of Cancer-Related Pathogens and Immunity, Department of Microbiology and Immunology, Institute of Molecular Virology and Immunology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
J Gastrointest Oncol. 2023 Oct 31;14(5):2134-2145. doi: 10.21037/jgo-23-543. Epub 2023 Sep 28.
Elderly people and patients with colorectal cancer (CRC) are both at high risk of malnutrition. Therefore, it is of great significance to explore suitable malnutrition screening and diagnostic indicators for elderly patients with CRC. Recently, the Global Leadership Initiative on Malnutrition (GLIM) proposed new diagnostic criteria for malnutrition. The aim of this article was to evaluate the diagnostic value of GLIM criteria for malnutrition in elderly colorectal patients. We explored the relationship between GLIM-malnutrition, post-operative complications and the long-term prognosis of elderly colorectal patients.
Elderly patients (aged ≥65 years) who underwent CRC surgery from January 2015 to December 2018 were included. Malnutrition was diagnosed based on the GLIM criteria. The relationships between GLIM-malnutrition and clinical characteristics were analyzed by -tests, Mann-Whitney tests, and chi-squared tests. The relationships between GLIM-malnutrition and post-operative complications were analyzed by chi-squared tests, and logistic regression analyses. The relationships between GLIM-malnutrition and the long-term prognosis were analyzed by Kaplan-Meier analyses and logistic and Cox regression analyses.
A total of 385 elderly patients were included in this study, and 118 patients (30.65%) were diagnosed with malnutrition according to the GLIM criteria. GLIM-malnutrition was significantly associated with older age, lower body mass index (BMI), lower grip strength, tumor location, higher Nutrition Risk Screening 2002 (NRS-2002), and lower levels of albumin and hemoglobin. GLIM-malnutrition was an independent risk factor [odds ratio (OR): 1.753, 95% confidence interval (CI): 1.100-2.795, P=0.018] for post-operative complications. Cox regression analysis showed that GLIM-malnutrition was an independent risk factor for overall survival in elderly patients with CRC.
The GLIM criteria are feasible diagnostic criteria for malnutrition of elderly patients with CRC. GLIM-malnutrition is significantly associated with post-operative complications and overall survival in elderly patients with CRC.
老年人和结直肠癌（CRC）患者均面临较高的营养不良风险。因此，探索适用于老年CRC患者的营养不良筛查和诊断指标具有重要意义。近期，全球营养不良领导倡议组织（GLIM）提出了新的营养不良诊断标准。本文旨在评估GLIM标准对老年结直肠癌患者营养不良的诊断价值。我们探讨了GLIM-营养不良与老年结直肠癌患者术后并发症及长期预后之间的关系。
纳入2015年1月至2018年12月期间接受CRC手术的老年患者（年龄≥65岁）。根据GLIM标准诊断营养不良。采用t检验、Mann-Whitney检验和卡方检验分析GLIM-营养不良与临床特征之间的关系。采用卡方检验和逻辑回归分析GLIM-营养不良与术后并发症之间的关系。采用Kaplan-Meier分析以及逻辑回归和Cox回归分析GLIM-营养不良与长期预后之间的关系。
本研究共纳入385例老年患者，根据GLIM标准，118例患者（30.65%）被诊断为营养不良。GLIM-营养不良与年龄较大、体重指数（BMI）较低、握力较低、肿瘤位置、较高的营养风险筛查2002（NRS-2002）以及较低的白蛋白和血红蛋白水平显著相关。GLIM-营养不良是术后并发症的独立危险因素[比值比（OR）：1.753，95%置信区间（CI）：1.100-2.795，P=0.018]。Cox回归分析表明，GLIM-营养不良是老年CRC患者总生存的独立危险因素。
GLIM标准是老年CRC患者营养不良的可行诊断标准。GLIM-营养不良与老年CRC患者的术后并发症及总生存显著相关。
