Subjective global assessment for nutritional screening and its impact on surgical outcomes: A prospective study in older patients with colorectal cancer.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-11-25 DOI:10.1007/s00423-024-03548-w

Fuminori Teraishi, Yusuke Yoshida, Ryohei Shoji, Nobuhiko Kanaya, Yuki Matsumi, Kunitoshi Shigeyasu, Yoshitaka Kondo, Shunsuke Kagawa, Rie Tamura, Yoshikazu Matsuoka, Hiroshi Morimatsu, Toshiharu Mitsuhashi, Toshiyoshi Fujiwara

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Abstract

Purpose: Our perioperative management center provides preoperative intervention and functional and nutritional assessments for colorectal cancer patients aged over 75 years. This study evaluated the associations of preoperative nutritional status with postoperative outcomes and prognosis in colorectal cancer patients aged 75 years or older.

Methods: This was a prospective, observational study of 71 colorectal cancer patients aged 75 years or older who underwent surgery between July 2020 and September 2022. The Subjective Global Assessment (SGA) was evaluated as a nutritional index. The patients were classified into three groups: SGA-A (well nourished), B (moderately malnourished), and C (severely malnourished), and the correlations with postoperative outcomes and prognosis were examined.

Results: The median age of the 71 patients (34 males, 37 females) was 78 (75-92) years, and their median body mass index (BMI) was 22.3 (13.4-31.9) kg/m². Forty-eight patients had colon cancer, and 23 had rectal cancer. On the SGA, 28 patients were SGA-A, 25 SGA-B, and 18 SGA-C. The SGA-B/C group had significantly higher BMI (p < 0.01) and more ICU admissions (p = 0.02). The G8 score was significantly lower (p = 0.03) in the SGA-B/C group, suggesting coexisting functional decline. In terms of postoperative outcomes, the SGA-B/C group had a significantly longer postoperative hospital stay (p = 0.04). The 3-year OS rates for all stages were 100% in the SGA-A group and 49.7% in the SGA-B/C group (p = 0.03), while the 3-year OS rates for patients excluding Stage IV were 100% in the SGA-A group and 68.5% in the SGA-B/C group, not significantly different (p = 0.14). The 3-year RFS rate was 95.5% in the SGA-A group and 65.3% in the SGA-B/C group (p = 0.15).

Conclusion: The SGA is a promising nutritional index associated with short-term outcomes in older patients undergoing colorectal cancer surgery. The SGA can be assessed in a few minutes during an outpatient visit, making it useful for routine clinical use.

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营养筛查的主观全面评估及其对手术结果的影响：一项针对老年结直肠癌患者的前瞻性研究。

目的：我们的围手术期管理中心为 75 岁以上的结直肠癌患者提供术前干预以及功能和营养评估。本研究评估了 75 岁以上结直肠癌患者术前营养状况与术后结果和预后的关系：这是一项前瞻性观察研究，研究对象是在 2020 年 7 月至 2022 年 9 月期间接受手术的 71 名 75 岁或以上结直肠癌患者。主观全面评估（SGA）作为营养指数进行评估。患者被分为三组：SGA-A 组（营养良好）、B 组（中度营养不良）和 C 组（严重营养不良），并研究了其与术后结果和预后的相关性：71 名患者（34 名男性，37 名女性）的中位年龄为 78（75-92）岁，中位体重指数（BMI）为 22.3（13.4-31.9）kg/m2。48 名患者患有结肠癌，23 名患者患有直肠癌。在 SGA 中，28 名患者为 SGA-A，25 名为 SGA-B，18 名为 SGA-C。SGA-B/C 组的 BMI 明显更高（p 结论：SGA-A 组的 BMI 明显低于 SGA-B/C 组：SGA 是与接受结直肠癌手术的老年患者的短期预后相关的一项有前途的营养指标。SGA 可在门诊就诊时几分钟内完成评估，因此非常适合常规临床使用。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.