喉开放性手术治疗喉癌后的营养状况和预后：NSQIP数据库研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-09-17 DOI:10.1002/lio2.70257

Emma R. Thompson, Nour Abdel-Azim, Kenneth Yan

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引用次数: 0

摘要

目的：营养不良和体重减轻对喉癌患者免疫功能和伤口愈合的影响。了解体重过轻状况如何影响结果对改善护理至关重要。因此，我们评估了接受喉癌切除术患者的围手术期预后，并对近期意外体重减轻的患者进行了二次关注。方法：本回顾性队列研究使用美国外科医师学会国家手术质量改进计划数据库。CPT代码用于识别因癌症而接受开放式全喉或部分喉切除术的患者。结果：分析了2012例患者：体重不足276例（女性79例，男性197例），体重正常1736例（女性306例，男性1430例）。体重不足患者的年龄分布分别为2.5%（20-44岁）、76.1%（45-69岁）和21.4%（70-90岁），而体重正常患者的年龄分布分别为2.9%、66.7%和30.1%。体重过轻的患者更有可能出现医疗并发症（p p = 0.002），需要更多的输血（p p = 0.046），需要输血（p p = 0.119）或住院时间延长（p = 0.225）。结论：体重过轻和近期体重减轻与围手术期医学并发症和输血风险增加有关。术前优化可提高手术恢复和预后。证据等级：三级。

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Nutritional Status and Outcomes Following Open Laryngeal Surgery for Laryngeal Cancer: A NSQIP Database Study

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Nutritional Status and Outcomes Following Open Laryngeal Surgery for Laryngeal Cancer: A NSQIP Database Study

Objectives

Malnutrition and weight loss in patients with laryngeal cancer impair immune function and wound healing. Understanding how underweight status impacts outcomes is crucial to improving care. Accordingly, we evaluated perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer, with a secondary focus on patients with recent unintentional weight loss.

Methods

This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database. CPT codes were used to identify patients undergoing open total or partial laryngectomies for cancer. Only those with underweight (< 18.5) or normal weight (18.5–29.9) BMIs were included. A subgroup analysis assessed patients with recent unintentional weight loss. Univariate and multivariate analyses were performed, with significance set at p < 0.05.

Results

2012 patients were analyzed: 276 underweight (79 female, 197 male) and 1736 normal weight (306 female, 1430 male). Age distribution among underweight patients was 2.5% (ages 20–44), 76.1% (ages 45–69), and 21.4% (ages 70–90), compared to 2.9%, 66.7%, and 30.1%, respectively, in normal-weight patients. Underweight patients were more likely to experience medical complications (p < 0.001), longer hospital stays (p < 0.001), wound disruptions (p = 0.002), and to have greater transfusion requirements (p < 0.001). In those with recent, unintentional weight loss, underweight individuals were at increased risk of experiencing medical complications (p = 0.046) and requiring a transfusion (p < 0.001), but were not more likely to experience wound disruptions (p = 0.119) or experience increased lengths of stay (p = 0.225).

Conclusion

Underweight status and recent weight loss are associated with heightened risks of perioperative medical complications and transfusions. Preoperative optimization may enhance surgical recovery and outcomes.