| Objective To analyze the relationship between preoperative nutritional indicators and various clinical observation indicators of patients with gastric cancer after surgery,and to explore the predictive value of preoperative nutritional indicators in postoperative complications.Methods The clinical data of patients undergoing radical gastrectomy for gastrointestinal surgery at the First Affiliated Hospital of Guangxi Medical University from December 2015 to August 2019 were collected.Nutritional indicators included nutritional risk screening 2002(NRS 2002),PatientGenerated Subjective Global Assessment(PG-SGA),nutritional risk index(NRI)and prognostic nutrition index(PNI).Clavien-Dindo scoring system was used to classify postoperative complications.We analyzed the correlation of nutritional indicators with clinical parameters and traditional nutritional indicators,and further explore the differences of clinical observation indicators in different nutritional indicators groups.Univariate and multivariate logistic regression analysis were used to analyze the predictive value of nutritional indicators in postoperative complications of gastric cancer patients.Results A total of 572 patients with gastric cancer were included in this study,of which 53.8%(308/572)had nutritional risk(NRS 2002 ≥ 3 points),and 46.2%(264/572)had no nutritional risk(NRS 2002 <3 points).Among the enrolled gastric cancer patients,89 patients were well-nourished(PG-SGA A: 0-1 points),373 patients had suspicious or moderate malnutrition(PG-SGA B: 2-8 points)and110 patients had severe malnutrition(PG-SGA C: ≥9 points).Grouped according to NRI value,there were 209 patients with low NRI value,and the incidence of malnutrition was 36.5%;while grouped according to PNI value,the incidence of malnutrition was 28.1%(161/572).In this study,72(12.6%)patients had postoperative complications,of which 47 were grade II,18 were grade III,and 7were grade IV.The results show that the NRS 2002 score,PG-SGA score,NRI and PNI values have a good correlation with BMI,albumin and other traditional nutrition indicators(P<0.05).Patients with nutritional risks before surgery had significantly longer postoperative bowel function recovery time,first time out of bed,and total hospital stay than patients without nutritional risks(P <0.05).After grouping according to the PG-SGA score,the recovery time of intestinal function in patients with severe malnutrition was significantly longer than that in patients with moderate malnutrition and good nutrition,the difference was statistically significant(P<0.05).Patients in the three groups(PG-SGA A,B,and C)had the first postoperative bed activity time,total hospitalization time,and postoperative hospitalization time increasing in sequence,and the difference between the groups was statistically significant(P<0.05).Univariate logistic regression results showed that preoperative serum high CA153,high AFP levels,open surgery,preoperative nutritional risk and malnutrition are risk factors affecting postoperative complications(P<0.05).Multivariate logistic regression analysis showed that the NRS 2002 score(OR = 2.877;95% CI: 1.513-5.470;P=0.001),PG-SGA score(OR = 1.644;95% CI: 1.020-2.648;P=0.041)were independent predictors of postoperative complications in gastric cancer patients.Conclusion NRS 2002 and PG-SGA are suitable for preoperative nutrition screening and evaluation of patients with gastric cancer.The preoperative nutritional risks and malnutrition are closely related to postoperative intestinal function and prolonged recovery time of the body.The NRS 2002 score and PGSGA score were independent predictors of postoperative complications in gastric cancer patients.Reasonable nutritional treatment for patients with nutritional risks before surgery will help correct the malnutrition of patients,promote the recovery of gastrointestinal function after surgery,reduce postoperative complications,shorten hospital stay,save medical resources and improve the patient’s clinical outcome. |
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