低握力及握力不对称对老年结直肠癌患者术后结局的预测效能研究  

Predictive efficacy of low grip strength and grip asymmetry on postoperative outcomes in elderly patients with colorectal cancer

作　　者：丁玲玉 胡洁蔓 孙跃明 姚翠 DING Lingyu;HU Jieman;SUN Yueming;YAO Cui(Department of Colorectal Surgery,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial People′s Hospital,Nanjing,Jiangsu,210029;College of Medicine of Jiangsu University,Zhenjiang,Jiangsu,212013)

机构地区：[1]南京医科大学第一附属医院/江苏省人民医院结直肠外科,江苏南京210029 [2]江苏大学医学院,江苏镇江212013

出　　处：《实用临床医药杂志》2024年第12期77-81,91,共6页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金资助项目(82273406)。

摘　　要：目的观察低握力及握力不对称对老年结直肠癌患者多种术后结局的预测效能。方法选取2022年11月—2023年6月257例老年结直肠癌患者为研究对象,收集所有患者的一般资料、握力指标及术后不良结局等数据。通过Logistic回归分析探讨低握力及握力不对称与术后结局的关系。绘制受试者工作特征曲线,分析握力值及握力比值单独与联合应用对患者并发症的预测效能。结果握力值、握力比值、握力值联合握力比值可有效预测并发症的发生情况,曲线的曲线下面积(AUC)和(95%CI)分别为0.649(0.587~0.707)、0.627(0.565~0.686)、0.672(0.611~0.729)。握力比值、握力值联合握力比值可有效预测住院时间延长,AUC(95%CI)分别为0.671(0.610~0.728)、0.577(0.514~0.638)。握力值、握力值联合握力比值可有效预测衰弱的发生,AUC(95%CI)分别为0.585(0.522~0.646)、0.586(0.523~0.647)。结论本研究创新性地揭示了多种握力指标对结直肠癌患者术后结局的预测效能,低握力及握力不对称可有效预测患者并发症的发生,握力不对称可有效预测患者住院时间延长,低握力可有效预测患者衰弱的发生。Objective To observe the efficacy of low grip strength and grip asymmetry in predicting multiple postoperative outcomes in elderly patients with colorectal cancer.Methods A total of 257 elderly colorectal cancer patients were selected as study objects.Data on general information,grip strength indicators and adverse postoperative outcomes were collected from all patients.Associations of low grip strength,grip asymmetry with adverse postoperative outcomes were explored by Logistic regression.Receiver operating characteristic curves were plotted to further analyze the efficacy of low grip strength and grip asymmetry alone and their combination in predicting adverse outcomes of patients.Results Grip strength,grip strength ratio,and the combination of grip strength and grip strength ratio could effectively predict the occurrence of complications.The areas under the curve(AUCs)and 95%confidence interval(95%CI)were 0.649(0.587 to 0.707),0.627(0.565 to 0.686),and 0.672(0.611 to 0.729)respectively.Grip strength ratio and the combination of grip strength and grip strength ratio could effectively predict prolonged hospital stays,with AUC(95%CI)of 0.671(0.610 to 0.728)and 0.577(0.514 to 0.638),respectively.Grip strength and the combination of grip strength and grip strength ratio could effectively predict the occurrence of frailty,with AUC(95%CI)of 0.585(0.522 to 0.646)and 0.586(0.523 to 0.647),respectively.Conclusion This study innovatively reveals the predictive efficacy of multiple grip strength indicators for postoperative outcomes in colorectal cancer patients.Low grip strength and grip asymmetry are effective in predicting the occurrence of complications in patients,grip asymmetry is effective in predicting the occurrence of prolonged hospitalization,and low grip strength is effective in predicting the occurrence of frailty in elderly patients with colorectal cancer.

关 键 词：低握力 握力不对称 并发症 住院时间 衰弱 再入院 

分 类 号：R735.3[医药卫生—肿瘤] R49[医药卫生—临床医学] R473