Gait speed predicts post-operative medical complications in elderly gastric cancer patients undergoing gastrectomy
Gait speed predicts post-operative medical complications in elderly gastric cancer patients undergoing gastrectomy
复制标题
步态速度可预测接受胃切除术的老年胃癌患者的术后并发症
DOI：
10.1111/ans.14325
复制
发表时间：
2018-07-01
影响因子：
1.7
通讯作者：
Shen, Xian
中科院分区：
文献类型：
--
作者：
Chandoo, Arvine;Chi, Chu-Huai;Shen, Xian
背景步态速度是一项可以衡量老年胃病患者身体机能的临床结果。本研究的目的是确定步态速度在预测接受根治性胃切除术的老年患者术后并发症中的重要性。方法我们对 357 名接受根治性胃切除术的老年患者（65 岁）进行了一项前瞻性研究。术前步态速度是在 6 米光线充足、无障碍的走廊中测量的。对患者术后临床结果进行随访。采用单变量和多变量分析影响术后并发症的因素。 结果 357 例患者中有 95 例 (26.61%) 存在步态缓慢，这与年龄 (P < 0.001)、性别 (P = 0.016)、血浆白蛋白 (P < 0.001)、美国麻醉医师协会分级 (P = 0.012）、肿瘤淋巴结转移分级（P = 0.007）、肌肉减少症（P < 0.001）、握力（P < 0.001）和术后并发症（P = 0.022）。单因素分析显示，年龄（P = 0.015）和慢步态速度（P = 0.029）是术后并发症的危险因素。在多变量分析中，我们发现年龄（P < 0.001）和慢步速（P = 0.029）是术后并发症的独立预测因素。 结论 慢步速是接受根治性胃切除术的老年患者术后并发症的独立预测因素。这些患者应接受适当的围手术期营养支持和体育锻炼，这可以提高步态速度并降低术后并发症的风险。
BackgroundGait speed is a clinical outcome that can measure the physical performance of elderly gastric patients. The purpose of this study was to determine the importance of gait speed in predicting post-operative morbidities in elderly patients undergoing curative gastrectomy.MethodsWe conducted a prospective study of 357 elderly patients (65 years old) undergoing curative gastrectomy. Preoperative gait speed was measured in a 6-m well-lit and unobstructed hallway. Patients were followed up for the post-operative clinical outcomes. Factors contributing to the post-operative morbidities were analysed using univariate and multivariate analyses.ResultsSlow gait speed was present in 95 out of 357 patients (26.61%) which was significantly associated with age (P < 0.001), gender (P = 0.016), plasma albumin (P < 0.001), American Society of Anesthesiologists grade (P = 0.012), tumour-node-metastasis grade (P = 0.007), sarcopenia (P < 0.001), handgrip (P < 0.001) and post-operative medical complications (P = 0.022). In univariate analysis, age (P = 0.015) and slow gait speed (P = 0.029) were risk factors of post-operative complications. In multivariate analysis, we found that age (P < 0.001) and slow gait speed (P = 0.029) were independent predictors of post-operative medical complications.ConclusionSlow gait speed is an independent predictor of post-operative medical complications in elderly patients undergoing curative gastrectomy. Those patients should be managed with appropriate perioperative nutritional support and physical exercise which can improve gait speed and reduce the risk of post-operative medical complications.