| Research BackgroundMalnutrition is still the focus of attention in the treatment of cancer patients.At present,there are many nutritional screening and evaluation tools in the international medical field,but the results of their clinical value are inconsistent,and there are unclear indicators for the nutritional evaluation of patients in gastric cancer surgery.The literature shows that the nutritional status of gastric cancer patients is closely related to postoperative complications,psychology status and quality of life.Therefore,finding a nutritional evaluation system is more compatible with such patients.And it will help to guide clinical nutritional treatment and evaluate the clinical outcome of patients well.The CONUT score is simple to use and the evaluation results are objective,which may become a better nutritional evaluation tool.Research Purpose1.Describe the correlation between the complication,psychology and quality of life in patients with gastric cancer surgery and the correlation between the CONUT score;2.Describe the correlation between possible related indicators of the nutritional status of patients undergoing gastric cancer surgery and postoperative complications;3.Analyze whether the CONUT score is an independent risk factor for postoperative complications,psychological status and long-term quality of life in patients with gastric cancer surgery;4.Compare the value of CONUT score with PNI and ALB in evaluating postoperative complications,psychology and quality of life in patients with gastric cancer surgery.MethodA retrospective research design was used to collect the clinical data of gastric cancer patients who underwent surgical treatment in 168 of the General Surgery Department of Shaanxi Provincial People’s Hospital from 2014 to 2019.The CONUT score and PNI were used to score their nutritional status within 2 weeks before the operation,and the treatment during the hospitalization period was sorted.Strategies,whether complications occurred,etc.,and the CONUT score was divided into high and low groups according to the median of the study objects,and statistical analysis of the differences in basic information and complications between the two groups.The preoperative mental status,survival status and long-term quality of life after the operation of the enrolled patients were followed up by telephone or online until the follow-up date or the patient died.The questionnaire was filled in and the results were statistically analyzed.Result1.Excluding the population lost to follow-up,a total of 106 patients participated in this study.43 patients with preoperative CONUT score <5 accounted for 40.6%,and 39 patients with postoperative complications accounted for 36.8%.The gender of the patient,the occurrence of complications,survival time,CA19-9,retinol binding protein of surgical resection,etc.and the level of CONUT were statistically significant(P<0.05).Moreover,there were significant differences in S-AI,physical function,role function,general health status,and degree of financial difficulties among patients with high and low CONUT scores(P<0.05).2.Whether postoperative complications occurred was significantly related to the patient’s CONUT score,PNI,ALB,tumor stage,retinol binding protein,intraoperative blood loss,etc.(P<0.05).At the same time,postoperative complications and analysis of T-AI,physical function,role function,general health status,fatigue,pain,and financial difficulties were also statistically significant(P<0.05).3.In the multivariate analysis of complications,the CONUT score was found to be an independent risk factor for postoperative complications(P < 0.001).The multivariate analysis of the quality of life found that the patient’s pathological stage,CONUT level,and surgical method(laparoscopic or laparotomy)It is an independent risk factor for general health status(P<0.05).4.Use the ROC curve to compare the evaluation of CONUT,PNI and ALB in terms of postoperative complications,general health and STAI of patients,and found that compared with PNI and ALB,CONUT scores have better performance(AUC>0.5),especially In the evaluation of complications,the CONUT score AUC=0.7368,indicating that it has better use value.Conclusion1.CONUT score is closely related to the incidence of postoperative complications in patients with gastric cancer,and patients with higher scores have a higher risk of postoperative complications;2.The CONUT score has a significant correlation with the long-term quality of life of patients with gastric cancer,which can predict the clinical outcome of the patient to a certain extent;3.Compared with PNI and ALB,CONUT score is more valuable in evaluating postoperative complications and quality of life in patients with gastric cancer. |
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