Efficiency of Global Leadership Initiative on Malnutrition for nutritional assessment and prediction of postoperative complications in esophageal cancer
Zhou Lili, Wu Dan, Shi Haiyan
Department of Cardiothoracic Surgery Rugao People's Hospital Rugao 226500 Jiangsu China
Abstract：Objective This study aimed to evaluate the clinical value of Global Leadership Initiative on Malnutrition GLIM
criteria for the the diagnosis of malnutrition and prediction of short-term clinical outcomes in esophageal cancer who underwent curative
esophagectomy. Method This study included 158 esophageal cancer patients who were diagnosed and treated with curative esophagectomy
in Rugao People's Hospital of from January 2019 to January 2022. Nutritional Risk Screening 2002 NRS 2002 and GLIM criteria
were used for nutritional risk assessment and the diagnosis of malnutrition. All patients were divided into malnutrition and non -
malnutrition group according to the GLIM criteria and the short-term surgical outcomes between the two groups were compared. In
addition the univariate and multivariate Logistic regression analysis was conducted to determine the predictors of postoperative
complications Clavien-Dindo grade≥grade Ⅱ for esophageal cancer patients. Result The preoperative nutritional risk was detected
in 75 patients 47. 5% using NRS 2002 and the prevalence of malnutrition defined by GLIM criteria was 34. 2% 54 / 158 . Overall
11. 4% 18 / 158 of esophageal cancer patients had unintentional weight loss 10. 8% 17 / 158 had a low body mass index BMI and
16. 5% 26 / 158 were diagnosed with sarcopenia. Compared with the non-malnutrition group GLIM-defined malnutrition group had a
higher proportion of preoperative neoadjuvant chemotherapy
χ
2 = 4. 209 P= 0. 040 lower level of serum albumin 36. 7±5. 1 g / L
vs 38. 6±3. 7 g / L t = 2. 691 P = 0. 008 lower BMI 21. 0± 3. 4 kg / m
2
vs 23. 1± 2. 5 kg / m
2
t = 4. 195 P< 0. 001 and
skeletal muscle index at the third lumbar 40. 8±9. 4 cm
2
/ m
2
vs 46. 7±7. 3 cm
2
/ m
2
t = 4. 252 P<0. 001 . Moreover the length of hospital stays was longer t = -2. 152 P= 0. 033 the rates of postoperative complications
χ
2 = 3. 842 P = 0. 044 and ClavienDindo≥ grade Ⅱ
χ
2 = 5. 026 P = 0. 025 were higher especially for anastomotic leakage
χ
2 = 4. 478 P = 0. 034 and
pneumonia
χ
2 = 9. 459 P = 0. 002 in malnutrition group than in non - malnutrition group. Univariate and multivariate logistic
regression analysis demonstrated that preoperative hypoalbuminemia OR = 3. 784 95%CI = 1. 294-11. 070 P = 0. 015 and GLIMdefined malnutrition OR= 2. 834 95%CI = 1. 142-7. 029 P= 0. 025 were independent risk factors of postoperative complications for
esophageal cancer patients who underwent curative esophagectomy. Conclusion GLIM is an useful tool to evaluate the preoperative
nutritional status and predict the risk of postoperative complications and it could help surgeons to optimize the clinical management of
esophageal cancer patients
收稿日期: 2022-06-10
基金资助:南通市基础研究和民生科技计划指导性项目 MSZ21035
通讯作者:
石海燕 电子邮箱 2621916791@ qq. com
引用本文:
周丽丽,吴 丹,石海燕. 评价 GLIM 标准对食管癌营养评估与术后并发症预测
的有效性[J]. 肿瘤代谢与营养电子杂志, 2022, 9(5): 594-601.
Zhou Lili, Wu Dan, Shi Haiyan. Efficiency of Global Leadership Initiative on Malnutrition for nutritional assessment and prediction of postoperative complications in esophageal cancer. Electron J Metab Nutr Cancer, 2022, 9(5): 594-601.
