不同营养指标对老年胃肠道肿瘤病人术后衰弱的预测价值

doi:10.3969/j.issn.1003-9198.2024.02.012

Abstract

Abstract: Objective To analyze the different nutritional indexes affecting postoperative frailty in the elderly patients with gastrointestinal tumor, and to explore their predictive value for frailty. Methods A total of 315 elderly patients with gastrointestinal tumors were enrolled in this study from the surgical ward of the First Affiliated Hospital of Anhui Medical University from December 2021 to July 2022. According to the Chinese version of Tilburg scale, the patients were divided into frailty group(n=180) and non-frailty group(n=135). The demographic data, disease data and nutrition-related data of the two groups were collected. Multivariate Logistic regression analysis was used to analyze the influencing factors of postoperative frailty in the elderly patients with gastrointestinal tumors. Receiver operating characteristic(ROC) curve of different nutritional indexes to predict postoperative frailty was drawn, and the area under ROC curve(AUC) was calculated to compare the predictive value of the nutritional indexes. Results There were significant differences in age, body mass index(BMI), preoperative frailty, tumor location, operation mode, pathological stage, geriatric nutritional risk index(GNRI), prognostic nutritional index(PNI), hemoglobin(Hb), serum albumin(ALB) and nutritional risk screening 2002(NRS2002) score between the two groups(P<0.01). Logistic regression analysis showed that tumor location, GNRI, Hb and NRS2002 score were the independent influencing factors of postoperative frailty in the elderly patients with gastrointestinal tumors(P<0.05). The AUC of GNRI, Hb and NRS2002 in predicting postoperative frailty in the elderly patients with gastrointestinal tumors was 0.827(95%CI: 0.781-0.867), 0.767(95%CI: 0.717-0.813) and 0.699(95%CI: 0.645-0.749), respectively. The AUC of GNRI was greater than that of Hb(Z=2.112, P=0.035) and NRS2002(Z=3.665, P<0.001). Conclusions The assessment of preoperative nutritional status of elderly patients with gastrointestinal tumors by GNRI, Hb and NRS2002 can be used to predict postoperative frailty. GNRI may have the strongest predictive ability.

Key words: gastrointestinal tumor, aged, postoperative frailty, nutritional index, influencing factors

CLC Number:

LI Jiajia, WANG Mei, WU Changmei, GENG Lan. Predictive value of different nutritional indexes on postoperative frailty in elderly patients with gastrointestinal tumors[J]. Practical Geriatrics, 2024, 38(2): 157-161.

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Predictive value of different nutritional indexes on postoperative frailty in elderly patients with gastrointestinal tumors

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