低体质量指数与老年危重患者术后并发症风险的相关性分析

Correlation of low body mass index with risk for postoperative complications in critically ill elderly patients

目的评估老年患者术前体质量指数(BMI)与术后并发症发生风险的关系。方法本研究为对前期多中心随机对照研究中安慰剂组患者资料的二次分析。共纳入350例非心脏手术后入重症监护室(ICU)的老年患者(≥65岁)。主要终点是术后并发症发生情况。采用logistic回归模型分析术前BMI分级与术后并发症风险的关系。结果 350例患者中有35.1%(123例)发生术后并发症。logistic多因素回归分析显示,与正常体质量(BMI 18.5~23.9 kg/m^2)患者相比,体质量过低(BMI<18.5 kg/m2)伴随术后并发症风险增加(OR=2.210,95%CI 1.069~4.570,P=0.032);而超重和肥胖(BMI≥24.0 kg/m2)对术后并发症风险无明显影响(OR=0.820,95%CI 0.497~1.354,P=0.438)。结论对于在全身麻醉下非心脏手术后入ICU的老年患者,体质量过低伴随术后并发症风险增加。

Objective To investigate the relationship between preoperative body mass index （BMI） and the risk of postoperative complications in elderly patients.Methods This was a secondary analysis on the data derived from the patients of the placebo group in a previously published randomized controlled trial.A total of 350 elderly patients （≥65 years old） who were admitted to intensive care unit （ICU） after noncardiac surgery were recruited in this study.The primary endpoint was the occurrence of postoperative complications.Logistic regression model was used to analyze the relationship between preoperative BMI grade and the risk of postoperative complications.Results There were 35.1% of patients （123/350） developing postoperative complications.Logistic multivariate regression analysis showed that, compared with the normal weight patients （BMI 18.5-23.9 kg/m^2）, the underweight （BMI 〈18.5 kg/m^2） was associated with an increased risk of postoperative complications （OR=2.210, 95%CI： 1.069-4.570, P=0.032）, whereas overweightness and obesity （BMI ≥24.0 kg/m^2） had no such significant effect （OR=0.820, 95%CI： 0.497-1.354, P=0.438）.Conclusion For the elderly who were admitted to ICU after noncardiac surgery under general anesthesia, low preoperative BMI is associated with increased risk of postoperative complications.