Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eur J Oncol Nurs. 2024 Oct;72:102687. doi: 10.1016/j.ejon.2024.102687. Epub 2024 Aug 21.
To characterize subgroups with similar nutritional status trajectories during the 6-month period after pancreatectomy and to identify demographic and clinical characteristics influencing changes in nutritional status in each subgroup.
This longitudinal prospective study recruited 112 patients with newly diagnosed pancreatic tumor from an outpatient pancreatic surgical department of a medical center in northern Taiwan between September 2016 and April 2019. Patients completed a demographic and clinical characteristics form, the Mini Nutritional Assessment scale, and the Symptom Severity Scale prior to surgery (T0), 3 months after surgery (T1), and 6 months after surgery (T2). Latent class growth analysis was used to investigate the trajectories of nutritional status. Generalized estimating equations were used to identify significant factors influencing each trajectory.
Two latent groups of nutritional status trajectories were identified. Among 112 patients, 74.11% and 25.89% were classified as having high and low nutritional status trajectories, respectively. High nutritional status was significantly negatively correlated with changes in symptom severity. Low nutritional status was significantly negatively correlated with older age, surgical complications, and changes in symptom severity.
Symptom severity has the most significant negative effect on perioperative nutritional status. Older age and surgical complications exert negative effects on perioperative nutritional status among patients with low nutritional status. These findings emphasize the need for nurses to identify at-risk individuals and provide individualized nutritional care to improve nutritional status in this population.
This study was registered on ClinicalTrials.gov (trial registration number: NCT02900677; approved date: September 14th, 2016). Link: https://clinicaltrials.gov/ct2/show/NCT02900677.
描述胰腺切除术后 6 个月期间营养状况轨迹相似的亚组，并确定影响每个亚组营养状况变化的人口统计学和临床特征。
本纵向前瞻性研究招募了 2016 年 9 月至 2019 年 4 月期间来自台湾北部一家医学中心门诊胰腺外科部门的 112 名新诊断胰腺肿瘤患者。患者在手术前（T0）、手术后 3 个月（T1）和手术后 6 个月（T2）完成了人口统计学和临床特征表、迷你营养评估量表和症状严重程度量表。使用潜在类别增长分析来研究营养状况的轨迹。使用广义估计方程来确定影响每个轨迹的显著因素。
确定了两种营养状况轨迹的潜在类别。在 112 名患者中，74.11%和 25.89%分别归类为高和低营养状况轨迹。高营养状况与症状严重程度的变化呈显著负相关。低营养状况与年龄较大、手术并发症和症状严重程度的变化呈显著负相关。
症状严重程度对围手术期营养状况的影响最大。年龄较大和手术并发症对低营养状况患者的围手术期营养状况产生负面影响。这些发现强调了护士需要识别高危个体并为该人群提供个性化营养护理以改善营养状况的必要性。
本研究在 ClinicalTrials.gov 上注册（试验注册号：NCT02900677；批准日期：2016 年 9 月 14 日）。链接：https://clinicaltrials.gov/ct2/show/NCT02900677。
