{"title":"采用综合并发症指数评估全球营养不良领导倡议（GLIM）定义的营养不良对胆道癌切除术后并发症的影响。","authors":"Yuki Okazoe, Hiroaki Yanagimoto, Daisuke Tsugawa, Masayuki Akita, Takuya Mizumoto, Toshihiko Yoshida, Shinichi So, Jun Ishida, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto","doi":"10.1007/s00595-025-03051-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The Global Leadership Initiative on Malnutrition (GLIM) criteria, proposed in 2018, provide universal diagnostic standards for malnutrition, a known risk factor for postoperative complications in patients with various cancers. However, its impact on surgery for biliary tract cancer (BTC) remains unclear. This study evaluates the relationship between GLIM-defined malnutrition and postoperative complications after resection for BTC.</p><p><strong>Methods: </strong>The subjects of this retrospective study were patients who underwent pancreaticoduodenectomy or major hepatectomy with extrahepatic bile duct resection for BTC between January, 2013 and December, 2021. The comprehensive complication index (CCI), an indicator of postoperative complications, was calculated based on the total number and severity of postoperative complications.</p><p><strong>Results: </strong>GLIM-defined malnutrition was diagnosed in143 (71.1%) of the total 201 patients. The median CCI was significantly higher in the GLIM-defined malnutrition group than in the non-malnutrition group (37.2 vs. 28.3; P < 0.001). Multivariate logistic regression analysis revealed that GLIM-defined malnutrition (odds ratio 2.87 [95% confidence interval 1.38-5.96], P = 0.005) and intraoperative blood loss > 1,000 mL (odds ratio 3.77 [95% confidence interval 1.06-13.47], P = 0.041) were independent predictors of high morbidity (CCI ≥ 37.1).</p><p><strong>Conclusion: </strong>Preoperative GLIM-defined malnutrition was closely associated with increased postoperative complications in patients who underwent resection for BTC.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Using the comprehensive complication index to assess the impact of Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition on postoperative complications after resection for biliary tract cancer.\",\"authors\":\"Yuki Okazoe, Hiroaki Yanagimoto, Daisuke Tsugawa, Masayuki Akita, Takuya Mizumoto, Toshihiko Yoshida, Shinichi So, Jun Ishida, Takeshi Urade, Yoshihide Nanno, Kenji Fukushima, Hidetoshi Gon, Shohei Komatsu, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto\",\"doi\":\"10.1007/s00595-025-03051-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The Global Leadership Initiative on Malnutrition (GLIM) criteria, proposed in 2018, provide universal diagnostic standards for malnutrition, a known risk factor for postoperative complications in patients with various cancers. However, its impact on surgery for biliary tract cancer (BTC) remains unclear. This study evaluates the relationship between GLIM-defined malnutrition and postoperative complications after resection for BTC.</p><p><strong>Methods: </strong>The subjects of this retrospective study were patients who underwent pancreaticoduodenectomy or major hepatectomy with extrahepatic bile duct resection for BTC between January, 2013 and December, 2021. The comprehensive complication index (CCI), an indicator of postoperative complications, was calculated based on the total number and severity of postoperative complications.</p><p><strong>Results: </strong>GLIM-defined malnutrition was diagnosed in143 (71.1%) of the total 201 patients. The median CCI was significantly higher in the GLIM-defined malnutrition group than in the non-malnutrition group (37.2 vs. 28.3; P < 0.001). Multivariate logistic regression analysis revealed that GLIM-defined malnutrition (odds ratio 2.87 [95% confidence interval 1.38-5.96], P = 0.005) and intraoperative blood loss > 1,000 mL (odds ratio 3.77 [95% confidence interval 1.06-13.47], P = 0.041) were independent predictors of high morbidity (CCI ≥ 37.1).</p><p><strong>Conclusion: </strong>Preoperative GLIM-defined malnutrition was closely associated with increased postoperative complications in patients who underwent resection for BTC.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-025-03051-9\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03051-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的：2018年提出的全球营养不良领导倡议（GLIM）标准为营养不良提供了通用诊断标准，营养不良是各种癌症患者术后并发症的已知危险因素。然而，其对胆道癌（BTC）手术的影响尚不清楚。本研究评估了gim定义的营养不良与BTC切除术后并发症之间的关系。方法：本回顾性研究的对象为2013年1月至2021年12月因BTC行胰十二指肠切除术或肝大切除术合并肝外胆管切除术的患者。综合并发症指数（CCI）是术后并发症的一个指标，根据术后并发症的总数和严重程度计算。结果：在201例患者中，有143例（71.1%）被诊断为营养不良。营养不良组的CCI中位数显著高于非营养不良组(37.2 vs 28.3；p1000 mL（优势比3.77[95%可信区间1.06-13.47],P = 0.041）是高发病率（CCI≥37.1）的独立预测因子。结论：术前营养不良与BTC切除术患者术后并发症的增加密切相关。
Using the comprehensive complication index to assess the impact of Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition on postoperative complications after resection for biliary tract cancer.
Purpose: The Global Leadership Initiative on Malnutrition (GLIM) criteria, proposed in 2018, provide universal diagnostic standards for malnutrition, a known risk factor for postoperative complications in patients with various cancers. However, its impact on surgery for biliary tract cancer (BTC) remains unclear. This study evaluates the relationship between GLIM-defined malnutrition and postoperative complications after resection for BTC.
Methods: The subjects of this retrospective study were patients who underwent pancreaticoduodenectomy or major hepatectomy with extrahepatic bile duct resection for BTC between January, 2013 and December, 2021. The comprehensive complication index (CCI), an indicator of postoperative complications, was calculated based on the total number and severity of postoperative complications.
Results: GLIM-defined malnutrition was diagnosed in143 (71.1%) of the total 201 patients. The median CCI was significantly higher in the GLIM-defined malnutrition group than in the non-malnutrition group (37.2 vs. 28.3; P < 0.001). Multivariate logistic regression analysis revealed that GLIM-defined malnutrition (odds ratio 2.87 [95% confidence interval 1.38-5.96], P = 0.005) and intraoperative blood loss > 1,000 mL (odds ratio 3.77 [95% confidence interval 1.06-13.47], P = 0.041) were independent predictors of high morbidity (CCI ≥ 37.1).
Conclusion: Preoperative GLIM-defined malnutrition was closely associated with increased postoperative complications in patients who underwent resection for BTC.
期刊介绍：
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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