1.Dynamic change of nutritional risk in hepatological surgery patients during hospitalization: a prospective survey
Lei LI ; Xin YANG ; Peng LIU ; Pengxue LI ; Hongyuan CUI ; Chengyu LIU ; Mingwei ZHU ; Junmin WEI
Chinese Journal of Clinical Nutrition 2021;29(6):321-325
Objective:To investigate the dynamic change of nutritional risk in hepatological surgical patients during hospitalization.Methods:Anthropometric measurement and laboratory examination were conducted within 24 hours both after admission and before discharge. NRS 2002 was used to assess patients' nutritional status. The correlation between nutritional status and clinical outcomes was also analyzed.Results:A total of 600 patients were included in the study, among whom 401 were with benign diseases and 199 with malignant tumors. Compared with those values at admission, patients' weight, BMI, grip strength, calf circumference and main serum protein indicators decreased significantly at discharge ( P<0.05). The incidence of nutritional risk at discharge was 57.3%, higher than that at admission ( χ 2=6.512, P=0.011). The incidence of nutritional risk showed a significant increase during hospitalization in hepatological surgery patients ( P<0.05). Conclusions:Hepatological surgery patients were at high nutritional risk, which increased during hospitalization. The whole-course nutrition management of surgical patients should be given more attention.
2.Analysis of correlation between nutritional status and frailty and sarcopenia in geriatric patients planning to receive major hepatopancreatobiliary surgery
Pengxue LI ; Lijuan WANG ; Yifu HU ; Bo CHENG ; Lili DING ; Lei LI ; Junmin WEI ; Jinghai SONG ; Jingyong XU
Chinese Journal of Clinical Nutrition 2023;31(2):87-94
Objective:To analyze the correlation between nutritional status and frailty and sarcopenia in geriatric inpatients (GIPs) planning to receive major hepatopancreatobiliary (HPB) surgery.Methods:From December, 2020 to September, 2022, GIPs who were planning to receive major HPB surgery were recruited. Nutritional assessment was performed using nutritional risk screening 2002 (NRS-2002) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty and sarcopenia assessment were performed using Fried frailty phenotype (FFP) and Asian Working Group for Sarcopenia (AWGS) 2019 consensus on sarcopenia diagnosis and treatment. The prevalence and concurrence of malnutrition, frailty and sarcopenia were investigated, and the correlation between nutritional status and frailty and sarcopenia was analyzed.Results:A total of 144 participants at the mean age of (70.10±7.44) years were included. The prevalence of nutritional risk, malnutrition, and severe malnutrition were 73.6% ( n ?=?106), 68.1% ( n ?=?98), and 34.7% ( n ?=?50) respectively. The prevalence of frailty was 20.8% ( n ?=?30) and that of sarcopenia was 35.4% ( n ?=?51). The prevalence of severe malnutrition increased significantly in older participants and the prevalence of nutritional risk, malnutrition and severe malnutrition decreased significantly with higher BMI. The prevalence was 35.4% (51/144) for concurrent sarcopenia and malnutrition, 19.4% (28/144) for frailty and malnutrition, 14.6% (21/144) for sarcopenia and weakness, and 14.6% (21/144) for sarcopenia, malnutrition, and weakness. There was a positive correlation between nutritional risk and frailty ( r = 0.603, P < 0.001). The risk of pre-frailty and frailty in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 31.830, P < 0.001). The risk of pre-frailty and frailty in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 36.727, P < 0.001). Logistic regression analysis showed that the risk of frailty in patients with severe malnutrition was 12.303 times higher than that in patients with normal nutrition status (95% CI: 2.592 to 58.409, P = 0.002). The risk of sarcopenia in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 13.982, P < 0.001). The risk of sarcopenia in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 37.066, P < 0.001). Conclusions:The prevalence and concurrence rate of malnutrition, frailty, and sarcopenia are high in GIPs undergoing major HPB surgery. GIPs with malnutrition are susceptible to frailty.