探索胰腺癌手术患者营养与功能状态及术后短期结局之间的联系。

Exploring the Link Between Nutritional and Functional Status and Short-Term Postoperative Outcomes in Patients Undergoing Pancreatic Cancer Surgery.

作者信息

Lidoriki Irene, Frountzas Maximos, Karanikki Eva, Mylonakis Adam, Kozadinos Alexandros, Tsikrikou Iliana, Kyriakidou Maria, Karydakis Lysandros, Stefanoudakis Dimitrios, Lampou Maria, Vailas Michail, Felekouras Evangelos, Toutouzas Konstantinos G, Schizas Dimitrios

机构信息

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.

Department of Occupational Medicine, Cambridge Health Alliance, Cambridge, MA 02145, USA.

出版信息

Life (Basel). 2025 May 18;15(5):803. doi: 10.3390/life15050803.

DOI:10.3390/life15050803

PMID:40430229

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12112883/

Abstract

BACKGROUND

Patients with pancreatic cancer are at increased risk of malnutrition and functional decline. This study aimed to identify preoperative nutritional and functional risk factors associated with postoperative complications.

METHODS

Adult patients with pancreatic cancer admitted to two university surgical departments in Athens, Greece, were included. Preoperative laboratory values, nutritional status, and functional status were assessed.

RESULTS

Among 96 patients included in this study, postoperative complications occurred in 69 (71.9%). Complication rates were significantly higher in patients with severe malnutrition (87.9% vs. 62.7%, = 0.015), low Geriatric Nutritional Risk Index (GNRI) (90.5% vs. 66.2%, = 0.023), low handgrip strength (91.7% vs. 61.5%, = 0.037), and low gait speed (90.5% vs. 63.6%, = 0.027). Major complications were linked to lower hemoglobin (Hb) (11.5 ± 1.9 vs. 12.8 ± 1.7 g/dL, = 0.001), lower hematocrit (HCT) (34.7 ± 5.4% vs. 38.4 ± 4.7%, = 0.001), and severe malnutrition (42.4% vs. 23.7%, = 0.05). Lower Hb, lower HCT, malnutrition, and greater waist circumference were associated with postoperative mortality. Longer hospital stays were correlated with weaker handgrip strength and slower gait speed.

CONCLUSION

Preoperative malnutrition and impaired functional status are significant predictors of adverse postoperative outcomes in pancreatic cancer surgery.

摘要

背景

胰腺癌患者发生营养不良和功能衰退的风险增加。本研究旨在确定与术后并发症相关的术前营养和功能风险因素。

方法

纳入希腊雅典两所大学外科收治的成年胰腺癌患者。评估术前实验室检查值、营养状况和功能状况。

结果

本研究纳入的96例患者中，69例（71.9%）发生了术后并发症。严重营养不良患者（87.9%对62.7%，P = 0.015）、老年营养风险指数（GNRI）低的患者（90.5%对66.2%，P = 0.023）、握力低的患者（91.7%对61.5%，P = 0.037）和步速慢的患者（90.5%对63.6%，P = 0.027）并发症发生率显著更高。主要并发症与血红蛋白（Hb）降低（11.5±1.9对12.8±1.7 g/dL，P = 0.001）、血细胞比容（HCT）降低（34.7±5.4%对38.4±4.7%，P = 0.001）和严重营养不良（42.4%对23.7%，P = 0.05）有关。Hb降低、HCT降低、营养不良和腰围增加与术后死亡率相关。住院时间延长与握力减弱和步速减慢相关。