Liang Wenquan, Liu Yuhua, Guo Xin, Ma Xiaonan, Yang Xiuxiu, Zhou Jing
Department of General Surgery of the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
Institute of Army Hospital Management, Innovative Medical Research Department, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
Surg Endosc. 2024 Dec;38(12):7217-7226. doi: 10.1007/s00464-024-11296-7. Epub 2024 Oct 9.
Postoperative ileus (POI) is a prevalent complication following abdominal surgery, leading to extended hospitalization and escalated medical expenses. Few studies have investigated the association between grip strength and POI after abdominal minimally invasive surgery (MIS).
A prospective multicenter cohort study was conducted using data from a prospectively registered database of patients undergoing abdominal MIS from March to December 2022. Grip strength levels were categorized and analyzed for their association with POI using multiple regression analysis with demographic adjustments. A smooth curve was generated to visualize the linear relationship.
Out of 501 eligible patients, 393 were analyzed, with 67 (17.05%) developing POI. Grip strength was significantly and independently associated with POI, with each 1 kg and 8.57 kg (SD) increase in grip strength resulting in ORs of 0.94 and 0.61, respectively. Grip strength categories specific to sex and age were significantly associated with POI incidence, with individuals in the high grip strength group having a lower risk. Subgroup analysis showed grip strength as a significant predictor of POI risk, especially for males and older individuals. Higher grip strength was associated with a significantly lower risk of POI in males (OR = 0.29, 95% CI 0.09-0.90, p = 0.031) and older adults over 60 years old (OR = 0.31, 95% CI 0.10-0.98, p = 0.046).
Grip strength can predict the occurrence of POI in patients undergoing abdominal MIS. This can help identify high-risk individuals and improve perioperative management for better outcomes.
术后肠梗阻（POI）是腹部手术后常见的并发症，会导致住院时间延长和医疗费用增加。很少有研究调查腹部微创手术（MIS）后握力与POI之间的关联。
使用2022年3月至12月接受腹部MIS患者的前瞻性注册数据库中的数据进行了一项前瞻性多中心队列研究。对握力水平进行分类，并通过人口统计学调整的多元回归分析来分析其与POI的关联。生成平滑曲线以可视化线性关系。
在501名符合条件的患者中，对393名进行了分析，其中67名（17.05%）发生了POI。握力与POI显著且独立相关，握力每增加1千克和8.57千克（标准差），比值比分别为0.94和0.61。特定性别和年龄的握力类别与POI发生率显著相关，高握力组个体的风险较低。亚组分析显示握力是POI风险的重要预测因素，尤其是对男性和老年人而言。较高的握力与男性（比值比=0.29，95%置信区间0.09 - 0.90，p = 0.031）和60岁以上老年人（比值比=0.31，95%置信区间0.10 - 0.98，p = 0.046）发生POI的风险显著降低相关。
握力可以预测接受腹部MIS患者中POI的发生。这有助于识别高危个体并改善围手术期管理以获得更好的结果。
