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老年胃癌患者衰弱和营养风险与术后肺部感染的相关性研究

Correlations of frailty and nutritional risk with postoperative pulmonary infection in elderly patients with gastric cancer

    摘要
  • 摘要:
    目的 探讨老年胃癌患者术前衰弱和营养风险与术后肺部感染的相关性。
    方法 选取2021年8月—2022年9月滨州医学院附属医院胃肠外科行限期手术的老年胃癌患者为研究对象，采用Fried衰弱表型量表和营养风险筛查(NRS2002)评估量表评估患者的衰弱和营养风险状况。观察和记录住院期间术后肺部感染的发生情况，分析衰弱和营养风险对老年胃癌患者术后肺部感染的预测效果。
    结果 共纳入患者217例，其中存在营养风险者106例(48.85%), 衰弱者72例(33.18%)。在同等营养风险(NRS2002评分≥3分)情况下，衰弱患者术后肺部感染的发生率高于非衰弱患者，差异有统计学意义(P < 0.01)。Logistic回归分析显示，在校正了相关因素后，衰弱是术后肺部感染发生的独立危险因素(OR=3.628, 95%CI: 1.528~8.611)。衰弱联合营养风险预测老年胃癌患者术后肺部感染的受试者工作特征(ROC)曲线的曲线下面积(AUC)为0.834(95%CI: 0.769~0.899), 高于单独应用衰弱、营养风险评估的0.763(95%CI: 0.685~0.841)、0.737(95%CI: 0.656~0.818), 差异有统计学意义(P < 0.01)。
    结论 当患者同时存在衰弱和营养风险时，术后肺部感染的发生风险最高; 衰弱联合营养风险评估可增强对老年胃癌患者术后肺部感染的预测效能。

     

    Abstract:
    Objective To explore the correlations of preoperative frailty and nutritional risk with postoperative pulmonary infection in elderly patients with gastric cancer.
    Methods Elderly patients with confine operation for gastric cancer in the Department of Gastrointestinal Surgery in the Affiliated Hospital of Binzhou Medical University from August 2021 to September 2022 were selected as the research objects, and the Fried Frailty Phenotype Scale and the Nutritional Risk Screening (NRS2002) Assessment Scale were used to evaluate the patient′s frailty and nutritional risk status. Occurrence of postoperative pulmonary infection during hospitalization was observed and recorded, and the effects of frailty and nutritional risk in predicting postoperative pulmonary infection in elderly patients with gastric cancer were analyzed.
    Results A total of 217 patients were recruited, including 106 cases (48.85%) with nutritional risk and 72 cases (33.18%) with frailty. Under the same condition of nutritional risk (NRS2002 score ≥ 3), the incidence of postoperative pulmonary infection in patients with frailty was significantly higher than that in patients without frailty (P < 0.01). Logistic regression analysis showed that frailty was an independent risk factor for postoperative pulmonary infection (OR=3.628; 95%CI, 1.528 to 8.611) after correction of relevant factors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for predicting postoperative pulmonary infection in elderly patients with gastric cancer by frailty combined with nutritional risk was 0.834 (95%CI, 0.769 to 0.899), which was significantly higher than 0.763 (95%CI, 0.685 to 0.841) by frailty and 0.737 (95%CI, 0.656 to 0.818) by nutritional risk (P < 0.01).
    Conclusion When patients have both frailty and nutritional risk, the risk of postoperative pulmonary infection is the highest; frailty combined with nutritional risk assessment can enhance the predictive efficiency of postoperative pulmonary infection in elderly patients with gastric cancer.

     

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