Yixian Guo, Yufeng Wang, Runkun Liu, Hanqi Li, Guozhi Yin, Hang Tuo, Yifeng Zhu, Yiheng Wang, Wei Yang, Zhikui Liu
{"title":"基于白蛋白水平和体重指数的术前营养不良对非肝硬化结直肠癌肝转移患者手术结果的影响","authors":"Yixian Guo, Yufeng Wang, Runkun Liu, Hanqi Li, Guozhi Yin, Hang Tuo, Yifeng Zhu, Yiheng Wang, Wei Yang, Zhikui Liu","doi":"10.3389/fsurg.2025.1512843","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Serum albumin level and body mass index (BMI), acting as indicators of nutritional status, are commonly applied to predict surgical outcomes in cancer patients. This study aimed to evaluate the impact of preoperative serum albumin level and BMI on the operative outcomes of noncirrhotic patients with colorectal cancer liver metastasis who underwent hepatectomy.</p><p><strong>Methods: </strong>This was a retrospective study of medical records from the period between January 2013 and December 2022. Preoperative malnutrition was defined as hypoalbuminemia with a serum albumin level of <35 g/L before surgery or a BMI of <18.5 kg/m<sup>2</sup> within 30 days before surgery. Multiple statistical methods were applied to analyze the data, including the two-independent sample <i>t</i>-test, analysis of variance, Chi-squared test, and multivariate analysis.</p><p><strong>Results: </strong>Among the 159 eligible patients, 42 (26.4%) were classified into the preoperative malnutrition group. The incidence of blood transfusion (45.24% vs. 18.80%, <i>P</i> = 0.040) was significantly higher in the malnutrition group. The drainage volume was significantly higher on the first day [65 (115) vs. 60 (80), <i>P</i> < 0.05] and the second day [50 (95) vs. 40 (79) <i>P</i> < 0.05] in the malnutrition group than that in the nonmalnutrition group. Postoperative hemoglobin levels were significantly lower in the malnutrition group (101.20 ± 2.43 vs. 108.76 ± 1.61, <i>P</i> = 0.015). Therefore, the incidence of grade Ⅱ or Ⅲ/Ⅳ complications was significantly higher in the malnutrition group (16.67% vs. 5.31% or 11.9% vs. 3.42%, <i>P</i> = 0.001), and the length of hospital stay was significantly extended [18 (12) vs. 15 (8), <i>P</i> = 0.002]. In the multivariate analysis, preoperative malnutrition [odds ratio (OR) = 5.548, 95% CI 1.508-20.413, <i>p</i> = 0.010] and operation time (OR = 1.009, 95% CI 1.002-1.016, <i>P</i> = 0.0011) were identified as independent predictors of postoperative complications.</p><p><strong>Conclusion: </strong>Preoperative malnutrition in patients who underwent hepatectomy for colorectal cancer liver metastasis was associated with worse surgical outcomes, especially aggrandizing the emergence of postoperative complications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1512843"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986716/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in noncirrhosis patients with colorectal liver metastasis.\",\"authors\":\"Yixian Guo, Yufeng Wang, Runkun Liu, Hanqi Li, Guozhi Yin, Hang Tuo, Yifeng Zhu, Yiheng Wang, Wei Yang, Zhikui Liu\",\"doi\":\"10.3389/fsurg.2025.1512843\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Serum albumin level and body mass index (BMI), acting as indicators of nutritional status, are commonly applied to predict surgical outcomes in cancer patients. This study aimed to evaluate the impact of preoperative serum albumin level and BMI on the operative outcomes of noncirrhotic patients with colorectal cancer liver metastasis who underwent hepatectomy.</p><p><strong>Methods: </strong>This was a retrospective study of medical records from the period between January 2013 and December 2022. Preoperative malnutrition was defined as hypoalbuminemia with a serum albumin level of <35 g/L before surgery or a BMI of <18.5 kg/m<sup>2</sup> within 30 days before surgery. Multiple statistical methods were applied to analyze the data, including the two-independent sample <i>t</i>-test, analysis of variance, Chi-squared test, and multivariate analysis.</p><p><strong>Results: </strong>Among the 159 eligible patients, 42 (26.4%) were classified into the preoperative malnutrition group. The incidence of blood transfusion (45.24% vs. 18.80%, <i>P</i> = 0.040) was significantly higher in the malnutrition group. The drainage volume was significantly higher on the first day [65 (115) vs. 60 (80), <i>P</i> < 0.05] and the second day [50 (95) vs. 40 (79) <i>P</i> < 0.05] in the malnutrition group than that in the nonmalnutrition group. Postoperative hemoglobin levels were significantly lower in the malnutrition group (101.20 ± 2.43 vs. 108.76 ± 1.61, <i>P</i> = 0.015). Therefore, the incidence of grade Ⅱ or Ⅲ/Ⅳ complications was significantly higher in the malnutrition group (16.67% vs. 5.31% or 11.9% vs. 3.42%, <i>P</i> = 0.001), and the length of hospital stay was significantly extended [18 (12) vs. 15 (8), <i>P</i> = 0.002]. 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引用次数: 0
摘要
背景：血清白蛋白水平和身体质量指数（BMI）作为营养状况的指标，通常用于预测癌症患者的手术结果。本研究旨在评估术前血清白蛋白水平和BMI对行肝切除术的非肝硬化结直肠癌肝转移患者手术结果的影响。方法：回顾性研究2013年1月至2022年12月期间的医疗记录。术前营养不良定义为术前30天内血清白蛋白水平为2的低白蛋白血症。采用两独立样本t检验、方差分析、卡方检验、多变量分析等多种统计方法对数据进行分析。结果：159例患者中，术前营养不良组42例（26.4%）。营养不良组输血发生率（45.24% vs. 18.80%, P = 0.040）显著高于营养不良组。第1天引流量明显增高[65（115）比60 (80),P P P = 0.015]。因此，营养不良组Ⅱ级或Ⅲ/Ⅳ级并发症发生率明显高于营养不良组（16.67%比5.31%或11.9%比3.42%,P = 0.001），住院时间明显延长[18（12）比15 (8),P = 0.002]。在多因素分析中，术前营养不良[比值比(OR) = 5.548, 95% CI 1.508 ~ 20.413, p = 0.010]和手术时间（OR = 1.009, 95% CI 1.002 ~ 1.016, p = 0.0011）被确定为术后并发症的独立预测因素。结论：结直肠癌肝转移行肝切除术患者术前营养不良与较差的手术效果相关，尤其增加了术后并发症的发生。
Impact of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in noncirrhosis patients with colorectal liver metastasis.
Background: Serum albumin level and body mass index (BMI), acting as indicators of nutritional status, are commonly applied to predict surgical outcomes in cancer patients. This study aimed to evaluate the impact of preoperative serum albumin level and BMI on the operative outcomes of noncirrhotic patients with colorectal cancer liver metastasis who underwent hepatectomy.
Methods: This was a retrospective study of medical records from the period between January 2013 and December 2022. Preoperative malnutrition was defined as hypoalbuminemia with a serum albumin level of <35 g/L before surgery or a BMI of <18.5 kg/m2 within 30 days before surgery. Multiple statistical methods were applied to analyze the data, including the two-independent sample t-test, analysis of variance, Chi-squared test, and multivariate analysis.
Results: Among the 159 eligible patients, 42 (26.4%) were classified into the preoperative malnutrition group. The incidence of blood transfusion (45.24% vs. 18.80%, P = 0.040) was significantly higher in the malnutrition group. The drainage volume was significantly higher on the first day [65 (115) vs. 60 (80), P < 0.05] and the second day [50 (95) vs. 40 (79) P < 0.05] in the malnutrition group than that in the nonmalnutrition group. Postoperative hemoglobin levels were significantly lower in the malnutrition group (101.20 ± 2.43 vs. 108.76 ± 1.61, P = 0.015). Therefore, the incidence of grade Ⅱ or Ⅲ/Ⅳ complications was significantly higher in the malnutrition group (16.67% vs. 5.31% or 11.9% vs. 3.42%, P = 0.001), and the length of hospital stay was significantly extended [18 (12) vs. 15 (8), P = 0.002]. In the multivariate analysis, preoperative malnutrition [odds ratio (OR) = 5.548, 95% CI 1.508-20.413, p = 0.010] and operation time (OR = 1.009, 95% CI 1.002-1.016, P = 0.0011) were identified as independent predictors of postoperative complications.
Conclusion: Preoperative malnutrition in patients who underwent hepatectomy for colorectal cancer liver metastasis was associated with worse surgical outcomes, especially aggrandizing the emergence of postoperative complications.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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