结直肠癌患者的BMI会影响术后住院时间——基于DACCA的真实世界数据研究  

BMI of colorectal cancer patients will affect post-operative hospital stay:a real world study based on DACCA

作　　者：刘勇[1] 刘桂娜 龚佳祺 汪晓东[1] 李立[1] 周总光[1] LIU Yong;LIU Guina;GONG Jiaqi;WANG Xiaodong;LI Li;ZHOU Zongguang(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine in Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院胃肠外科,成都610041 [2]四川大学华西临床医学院医学实力派学术社团,成都610041

出　　处：《中国普外基础与临床杂志》2021年第11期1486-1493,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省科技计划项目(项目编号:2021KJTS0055);四川大学大学生创新创业项目(项目编号:202110610640、202110611352)。

摘　　要：目的分析目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中,华西医院作为区域性中心所服务的结直肠患者人群的体质量指数(BMI)对住院流程的影响。方法本次数据分析选取的DACCA版本为2021年4月30日更新版,其中分析的数据项目包括:BMI、就诊日期、入院日期、手术日期、出院日期、入院前等候时间、术前住院时间、术后住院时间、总住院时间及管理流程。结果按照条件筛选DACCA数据库获得5564条可分析数据行,数据涵盖2007–2021年。患者的BMI为11.02~39.67 kg/m^(2)、(22.86±3.28)kg/m^(2),BMI值随“年”增长(y=0.058x–94.23,R^(2)=0.005,P<0.001)。BMI特征性分析结果显示:BMI与入院前等候时间、术前住院时间、总住院时间的关系无统计学意义(P>0.05),但是BMI值会影响患者的术后住院时间和流程管理(P<0.05)。其中,肥胖组较其他组有更短的术后住院时间(P=0.014)。此外,不同BMI的结直肠癌患者在管理流程上的差异存在统计学意义(χ^(2)=26.84,P=0.001),尽管“加速”管理占最大的比例(66.37%),但就每个流程管理分类而言,偏瘦人群更易选择“加强”管理流程(11.08%),肥胖人群更易选择“个体”流程管理(6.05%)。结论DACCA数据反映结直肠癌患者的BMI值有逐年增长的趋势。BMI与患者入院前等候时间、术前住院时间以及总住院时间没有明确的相关性,因此,从医院住院管理的角度上看,结直肠癌患者的住院运转能力不受到BMI影响。患者BMI值会影响术后住院时间以及流程管理,肥胖人群的术后住院时间更短且更容易选择非流程化的管理方式。Objective To analyze the impact of body mass index(BMI)on hospitalization process of colorectal cancer patients served by West China Hospital,based on the current version of Database from Colorectal Cancer(DACCA).Methods The data of DACCA was updated on April 30,2021.All data items included BMI,visiting data,admission date,operation date,discharging date,pre-hospitalization time,pre-operation time,post-operation time,total hospital stay,and management process.Results After scanning,5564 data rows were analyzed,from 2007 to 2021.The range of BMI was 11.02–39.67 kg/m^(2),the average of BMI was(22.86±3.28)kg/m^(2),and the BMI increased with year(y=0.058x–94.23,R^(2)=0.005,P<0.001).The results of BMI characteristic analysis showed that BMI was not statistically significant related to the pre-hospitalization time,the pre-operation time,and the total length of hospital stay(P>0.05).However,the BMI would affect patients’postoperative hospital stay and process management(P<0.05).Among them,obese group had shorter postoperative hospital stay than other groups(P=0.014).Additionally,there was significant difference in management process among colorectal cancer patients with different BMI(χ^(2)=26.84,P=0.001).In process management,“ERAS”management accounted for the largest proportion(66.37%),but for each process management category,lean people were more likely to choose“enhanced”management process(11.08%),and obese people were more likely to choose“individual”process management(6.05%).Conclusions The analysis results reflect that the BMI of colorectal cancer patients have an increasing trend year by year.BMI has no clear correlation with patients’waiting time before admission,pre-operative time,and total hospital stay.Therefore,from the perspective of hospitalization management,the hospitalization operation ability of patients with colorectal cancer was not affected by BMI.The BMI of patients will affect the postoperative hospital stay and process management.The obese people have a shorter postoperative

关 键 词：结直肠癌 BMI 数据库 住院管理 

分 类 号：R735.34[医药卫生—肿瘤]