Clinical significance of preoperative nutritional status in elderly gastric cancer patients undergoing radical gastrectomy:A singlecenter retrospective study  

作　　者：Xi-Ning Zhao Jing Lu Hong-Yong He Sheng-Jin Ge 

机构地区：[1]Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China [2]Department of Nursing,Zhongshan Hospital,Fudan University,Shanghai 200032,China [3]Department of General Surgery/Emergency Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第7期2211-2220,共10页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.82373417;Natural Science Foundation of Shanghai,No.23ZR1409900;Clinical Research Plan of SHDC,No.SHDC2020CR3048B;Clinical Research Fund of Zhongshan Hospital,Fudan University,No.ZSLCYJ202343.

摘　　要：BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer.AIM To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy.METHODS A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Fudan University between January 2018 and May 2020.RESULTS The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished group.The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed discharge.CONCLUSION Malnutrition is relatively common in elderly patients undergoing gastrectomy.Low PNI is an independent risk factor associated with delay discharge.More strategies are needed to improve the clinical outcome of these patients.

关 键 词：Gastric cancer Preoperative nutritional status MALNUTRITION ELDERLY Radical gastrectomy 

分 类 号：R656.61[医药卫生—外科学]