Preoperative sarcopenia is a predictor of postoperative pulmonary complications in esophageal cancer following esophagectomy: A retrospective cohort study
Preoperative sarcopenia is a predictor of postoperative pulmonary complications in esophageal cancer following esophagectomy: A retrospective cohort study
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DOI：
10.1016/j.jgo.2016.07.003
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发表时间：
2016-11-01
影响因子：
3
通讯作者：
Miura, Yasushi
中科院分区：
文献类型：
--
作者：
Makiura, Daisuke;Ono, Rei;Miura, Yasushi
目的：老年食管癌患者的数量呈上升趋势。老年综合征如肌肉减少症可能会对术后恢复产生不利影响。本研究的目的是评估肌肉减少症和术后并发症之间的关系，以及肌肉减少症和围手术期食管癌患者食管切除术后的功能变化之间的关联。材料和方法：参与者包括104例接受食管切除术，2011年7月至2015年4月。根据亚洲肌肉减少症工作组标准，术前肌肉减少症的诊断依据是存在低肌肉质量和低身体功能。身体功能低下定义为握力丧失和/或步行速度缓慢。提取术后肺部、心脏、感染和手术并发症。计算围手术期功能变化（术后30天的值-术前值）。统计分析，单因素和多因素Logistic回归分析进行了performed.Results：29例（27.9%）被诊断为肌肉减少症。术后肺部并发症的发生率在肌肉减少症组（37.9%）明显高于非肌肉减少症组（17.3%; P = 0.04）。肌肉减少症与其他并发症或围手术期功能变化之间无关系。多因素分析显示，肌肉减少（OR = 3.13，95%CI = 1.12-8.93）和Brinkman指数（OR = 3.46，95%CI = 1.20-11.77）是食管癌术后肺部并发症的独立危险因素。另一方面，肌肉减少症不能预测心脏、感染和手术并发症或围手术期功能。(C)2016爱思唯尔有限公司版权所有
Objectives: The number of geriatric patients with esophageal cancer has been increasing. Geriatric syndromes such as sarcopenia might adversely affect postoperative recovery. The aim of this study was to evaluate the relationships between sarcopenia and postoperative complications, and the associations between sarcopenia and perioperative functional changes in patients with esophageal cancer following esophagectomy.Materials and Methods: Participants comprised 104 patients who underwent esophagectomy from July 2011 to April 2015. Preoperative sarcopenia was diagnosed by the presence of low muscle mass and low physical functions according to Asian Working Group for Sarcopenia criteria. Low physical function was defined by loss of grip strength and/or slow walking speed. Postoperative pulmonary, cardiac, infectious, and surgical complications were extracted. Perioperative functional changes were calculated (value at postoperative day 30 - value before surgery). For statistical analyses, both uni- and multivariate logistic regression analyses were performed.Results: Twenty-nine patients (27.9%) were diagnosed with sarcopenia. The incidence of postoperative pulmonary complications was significantly higher in the sarcopenia group (37.9%) than in the non-sarcopenia group (17.3%; P = 0.04). There was no relationship between sarcopenia and other complications or perioperative functional changes. Multivariate analysis identified sarcopenia (odds ratio (OR), 3.13; 95% confidence interval (CI), 1.12-8.93) and high Brinkman index (OR, 3.46; 95% CI, 1.20-11.77) as independent risk factors for the development of pulmonary complications.Conclusion: The assessment of sarcopenia may be useful to predict the postoperative pulmonary complications following esophagectomy. On the other hand, sarcopenia does not predict cardiac, infectious, and surgical complications or perioperative function. (C) 2016 Elsevier Ltd. All rights reserved.