老年结直肠癌患者营养风险筛查及其对术后感染性并发症的影响

Nutritional risk screening for elderly patients with colorectal cancer and its impact on infectious complications

目的分析老年结直肠癌患者营养状况及其对术后感染性并发症的影响。方法回顾性收集解放军总医院第一医学中心2020年6月至2022年6月收治的782例老年结直肠癌患者的临床资料,对患者营养状况进行筛查,同时根据患者是否存在营养风险,将患者分为营养风险组(355例)和对照组(427例),比较两组患者主要临床特征和术后康复情况,分析营养相关指标对术后感染性并发症的预测价值。结果单因素分析结果表明,年龄、肿瘤侵犯肠壁肌层、血清白蛋白降低是老年结直肠癌患者营养风险的危险因素(P<0.05)。多因素分析结果表明,年龄≥75岁是老年结直肠癌患者存在营养风险的独立危险因素(RR=1.990,95%CI 1.402~2.825,P<0.01)。与对照组比较,营养风险组患者住院时间延长[(13.59±8.20)d比(11.91±5.04)d],术后并发症发生率增加[16.34%(58/355)比6.09%(26/427)],差异均有统计学意义(P<0.01)。老年营养风险指数<98、术前化疗是老年结直肠癌患者发生术后感染性并发症的危险因素(RR=2.982,95%CI 1.818~4.890,P<0.01;RR=2.759,95%CI 1.119~6.799,P<0.05)。结论老年结直肠癌患者存在营养风险的比例较高,年龄是导致营养风险的主要因素,营养风险可导致术后感染性并发症增加。

ObjectiveTo analyze the nutritional status of elderly patients with colorectal cancer and its impact on postoperative infectious complications.MethodsA retrospective collection was conducted on 782 colorectal cancer patients admitted to the First Medical Center of PLA General Hospital from June 2020 to June 2022.The nutritional status of the patients was screened,and they were divided into nutritional risk group(355 cases)and control group(427 cases)based on whether they had nutritional risk.The main clinical characteristics and postoperative recovery of the two groups were compared.The predictive value of nutritional related indicators for postoperative infectious complications was also analyzed.ResultsUnivariate analysis showed that age,tumor invasion of intestinal wall muscle layer and decreased serum albumin were risk factors for nutritional risk in elderly patients with colorectal cancer(P<0.05).The results of multivariate factor analysis showed that age≥75 years old was an independent risk factor for nutritional risk in elderly patients with colorectal cancer(RR=1.990,95%CI 1.402-2.825,P<0.01).Compared with the control group,patients in the nutrition risk group had longer hospital stay and an increased incidence of postoperative complications:(13.59±8.20)d vs.(11.91±5.04)d,16.34%(58/355)vs.6.09%(26/427),there were statistical differences(P<0.05).The results of multivariate factor analysis showed that elderly nutrition risk index<98,preoperative chemotherapy were risk factors for infectious complications in colorectal cancer patients(RR=2.982,95%CI 1.818-4.890,P<0.01;RR=2.759,95%CI 1.119-6.799,P<0.05).ConclusionsThe proportion of elderly patients with colorectal cancer who have nutritional risk is relatively high,and age is the main factor leading to nutritional risk.Nutritional risk can lead to an increase in postoperative infectious complications.