吞咽困难康复小组对老年胃癌患者的围手术期干预：反概率加权分析

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology Pub Date : 2024-10-24 DOI:10.1016/j.jgo.2024.102134

Atsushi Yasuda , Yutaka Kimura , Tsutomu Saito , Yoko Hiraki , Takaomi Hagi , Hiroaki Kato , Osamu Shiraishi , Masayuki Shinkai , Motohiro Imano , Takushi Yasuda

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引用次数: 0

摘要

导言本研究旨在评估接受胃切除术的老年胃癌患者围手术期吞咽困难康复治疗的疗效：这项回顾性研究纳入了 2000 年 1 月至 2020 年 12 月期间接受胃切除术的 149 名 80 岁以上患者。根据吞咽困难康复团队的干预将患者分为两组（DRT 组：n = 101）和非干预对照组（C 组：n = 48）。采用逆概率加权（IPW）分析，以减少潜在混杂因素造成的偏差：结果：DRT 组的总体并发症发生率明显降低（几率比 [OR]；0.27[0.08-0.93]），其中术后肺炎（OR；0.07[0.01-0.43]）和吸入性肺炎（OR；0.05[0.01-0.44]）的发生率明显降低。10 名患者出现术后肺炎，其中 C 组 7 人，DRT 组 3 人。其中 60% 的患者术前患有与呼吸系统相关的合并症。关于吸入性肺炎的发病时间，观察到两种模式：术后短时间内发病和开始进食后发病。相比之下，DRT 组有 5 名患者在术前接受了吞咽困难康复治疗。讨论：讨论：对吞咽困难康复的围手术期干预不仅能减少术后肺炎的发生，还能提高医务人员的认识，促进对患者吞咽情况的仔细观察，从而控制术后肺炎的发生率。吞咽困难康复小组的围手术期干预对老年胃癌患者很有帮助。

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Perioperative intervention of dysphagia rehabilitation team in older adults with gastric cancer: An inverse probability weighting analysis

Introduction

This study aimed to evaluate the efficacy of perioperative dysphagia rehabilitation in older adult patients diagnosed with gastric cancer who underwent gastrectomy.

Materials and Methods

This retrospective study included 149 patients over 80 years who underwent gastrectomies between January 2000 and December 2020. The patients were divided into two groups based on the intervention of the dysphagia rehabilitation team (DRT group: n = 101) and the non-intervention control group (C group: n = 48). Inverse probability weighting (IPW) analysis was used to reduce bias caused by potential confounding.

Results

The incidence of overall complications was significantly lower in the DRT group (odds ratio [OR]; 0.27[0.08–0.93]), among which the incidence of postoperative pneumonia (OR; 0.07[0.01–0.43]) and aspiration pneumonia (OR; 0.05[0.01–0.44] was significantly reduced. Ten patients developed postoperative pneumonia; seven were in the C group, and three were in DRT group. Sixty percent of these patients had preoperative comorbidities related to the respiratory system. Regarding the time of onset of aspiration pneumonia, two patterns were observed: onset within a short period after surgery and onset after the start of eating. In contrast, five patients underwent preoperative dysphagia rehabilitation in the DRT group. Among them, postoperative aspiration pneumonia was prevented in four patients, and the others were prevented from severe pneumonitis by the intervention of the dysphagia rehabilitation team.

Discussion

Perioperative intervention in dysphagia rehabilitation is not only associated with reduced postoperative pneumonia but also creates awareness in the medical staff and promotes careful observation of swallowing in patients, thereby controlling the incidence of postoperative pneumonia. The perioperative intervention of the dysphagia rehabilitation team is useful for older adult patients with gastric cancer.

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来源期刊

Journal of geriatric oncology ONCOLOGY-GERIATRICS & GERONTOLOGY

CiteScore

5.30

自引率

10.00%

发文量

379

审稿时长

80 days

期刊介绍： The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology. The journal welcomes the submission of manuscripts in the following categories: • Original research articles • Review articles • Clinical trials • Education and training articles • Short communications • Perspectives • Meeting reports • Letters to the Editor.