接受腹部大手术的癌症患者的术前免疫营养和术后预后:回顾性队列研究。

IF 2.9 Q3 NUTRITION & DIETETICS Clinical nutrition ESPEN Pub Date : 2025-02-01 DOI:10.1016/j.clnesp.2024.12.011
Mauricio Chona Chona , Lina Maria López Basto , Carolina Pinzón Ospina , Ana Cristina Pardo Coronado , María Paula Guzmán Silva , Marjorie Marín , Alvaro Vallejos , Gloria Esperanza Castro Osmán , Carlos Saavedra , Jorge Díaz Rojas , Jorge Medina-Parra , Ricardo Alfonso Merchán-Chaverra
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引用次数: 0

摘要

背景与目的:手术切除是癌症患者的一线治疗方法,但术前营养不良是术后并发症的危险因素。本研究旨在评估接受腹部大手术的癌症患者术前给予免疫营养方案与术后临床结果之间的关系。方法:2021年1月至2023年12月进行的外科康复多模式肿瘤学(SUPREMO)回顾性队列研究纳入了接受腹部大手术的癌症患者。根据患者是否接受完整的免疫营养方案或不完整或没有方案对患者进行分类。从电子健康记录中提取人口统计和临床数据进行描述性分析。采用Logistic回归评估免疫营养对感染性并发症风险的影响,并将临床和人口统计学变量作为解释因素。结果:共纳入620例患者,其中49%接受完整的术前免疫营养方案。双变量分析显示,完整的方案管理与较低的重症监护病房(ICU)入院率、有创机械通气(IMV)和血管加压素支持需求相关(p = 0.005、p = 0.019和p = 0.032)。logistic回归模型显示院内感染并发症显著减少(优势比0.54,95%可信区间0.31-0.98;P = 0.044)。结论:实施完整的术前免疫营养方案可能与减少感染并发症、ICU和IMV需求以及血管加压药物支持使用有关。
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Preoperative immunonutrition and postoperative outcomes in patients with cancer undergoing major abdominal surgery: Retrospective cohort study

Background and objectives

Surgical resection is a first-line treatment for patients with cancer, but preoperative malnutrition is a risk factor for postoperative complications. This study aimed to evaluate the association between preoperative administration of an immunonutrition regimen and postoperative clinical outcomes in patients with cancer undergoing major abdominal surgery.

Methods

The Surgical Prehabilitation Multimodal Oncology (SUPREMO) retrospective cohort study, conducted from January 2021 to December 2023, included patients with cancer undergoing major abdominal surgery. Patients were categorized based on whether they received a complete immunonutrition regimen or an incomplete or no regimen. Demographic and clinical data were extracted from electronic health records for descriptive analysis. Logistic regression was used to assess the impact of immunonutrition on the risk of infectious complications, with clinical and demographic variables as explanatory factors.

Results

A total of 620 patients were included, with 49 % receiving a complete preoperative immunonutrition regimen. Bivariate analysis indicated that complete regimen administration was associated with lower intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and vasopressor support requirements (p = 0.005, p = 0.019, and p = 0.032, respectively). The logistic regression model showed a significant reduction in in-hospital infectious complications (odds ratio 0.54, 95 % confidence interval 0.31–0.98; p = 0.044).

Conclusion

Administering a complete preoperative immunonutrition regimen may be associated with reduced infectious complications, ICU and IMV requirements, and vasopressor support use.
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来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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