基于倾向性评分匹配法比较术前贫血对胃癌术后近期疗效及远期预后的影响

Comparison of the effect of preoperative anemia on the short-term efficacy and long-term prognosis of gastric cancer surgery based on propensity score matching method

目的探讨基干倾向性评分匹配法比较术前贫血对胃癌术后近期疗效及远期预后的影响。方法选取2011年2月至2018年3月该院收治的胃癌患者1274例,依据是否贫血分为贫血组(372例)和非贫血组(902例)。采用倾向性评分匹配法按1∶1进行匹配,成功匹配328对患者。比较2组患者术后恢复情况及预后。结果1274例患者术前贫血发生率为29.2%(372/1274)。年龄、身体质量指数(BMI)、糖尿病、术前贫血、切除范围、手术时间是发生术后并发症的独立危险因素(P<0.05)。2组患者匹配前年龄、BMI、糖尿病、肿瘤大小、手术方式、病理分期比较,差异均有统计学意义(P<0.05);2组患者匹配后一般资料比较,差异均无统计学意义(P>0.05)。与非贫血组比较,贫血组患者并发症发生率更高,术后住院时间更长,差异均有统计学意义(P<0.05)。贫血组患者5年生存率明显低于非贫血组,差异有统计学意义(P<0.05)。结论术前贫血增加了术后并发症发生率,延长了术后恢复,且对远期预后造成不良影响。

Objective To investigate the comparison of the effect of preoperative anemia on short-term therapeutic outcomes and long-term prognosis after gastrectomy for gastric cancer based on propensity score matching method.Methods A total of 1274 patients with gastric cancer treated at our hospital from February 2011 to March 2018 were selected.Based on the presence or absence of anemia,they were divided into the anemia group(372 cases)and the non-anemia group(902 cases).Propensity score matching was performed in a 1∶1 ratio,successfully matching 328 pairs of patients.The postoperative recovery and prognosis were compared between the two groups.Results The incidence of preoperative anemia among the 1274 patients was 29.2%(372/1274).Age,body mass index(BMI),diabetes,preoperative anemia,extent of resection,and operative time were independent risk factors for postoperative complications(P<0.05).Before matching,significant differences were observed between the two groups in terms of age,BMI,diabetes,tumor size,surgical approach,and pathological stage(P<0.05).After matching,no significant differences were found in general characteristics between the two groups(P>0.05).Compared to the non-anemia group,the anemia group had higher rates of postoperative complications and longer hospital stays,both with statistical significance(P<0.05).The 5-year survival rate of the anemia group was significantly lower than that of the non-anemia group(P<0.05).Conclusion Preoperative anemia increases the incidence of postoperative complications,prolongs postoperative recovery,and adversely affects prognosis.