老年医学与保健2024，Vol.30Issue(4)：947-952,6.
老年早期胃癌患者内镜治疗术后伴发营养不良的风险预测模型构建
Construction of a risk prediction model for postoperative malnutrition in elderly patients with early gastric cancer after endo-scopic therapy
摘要
Abstract
Objective To analyze the influencing factors of malnutrition in elderly patients with early gastric cancer un-dergoing endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)at home.Methods 80 elderly patients who received ESD or EMR treatment for early gastric cancer in Jiangsu Provincial Hospital of Traditional Chinese Medi-cine from January 2022 to December 2023 were selected as the observation subjects.According to whether malnutrition occurred in the home environment after surgery,they were divided into malnutrition group(n=45)and non-malnutrition group(n=35).The high risk factors for malnutrition were investigated by univariate and multiple factor analysis.Results Univariate analysis showed that there was no statistically significant difference in the detection values of hypertension,blood potassium,blood glucose,and hemoglobin between the two groups(P＞0.05).The age,educational level,anxiety score,depression score,early satiety,personality traits,preoperative hypoalbuminemia,preoperative blood calcium,etc.of both groups were all associated with postoperative malnutrition(all P＜0.05).Logistic regression analysis showed that age＞75 years old,depres-sion score＞35 points,early satiety,anxiety score ≥29 points and preoperative hypoproteinemia were independent risk factors for postoperative malnutrition in gastric cancer patients(P＜0.05).Based on the newly generated probability values of the model,data validation was conducted on the model,and the ROC curve of the prediction model was plotted.It was found that AUC=0.862(95％CI=0.795-0.859)＞0.75,and the optimal critical value was 0.554.It indicated that the model had cer-tain predictive ability.Hosmer-Lemeshow test evaluated the calibration ability of the model(x2=0.879,P=0.761＞0.05),and the evaluated result suggested that the model had a good goodness of fit.The DCA results showed that when the critical probability of malnutrition was between 9％and 95％,the application of this model could achieve higher net benefits.Conclusion This study established a risk prediction model for postoperative malnutrition in elderly patients with early gastric cancer.Multivariate Logistic regression analysis shows that age＞75 years old,depression score＞35 points,early satiety,anx-iety score ≥29 points,preoperative hypoproteinemia may be independent risk factors.This model has good predictive ability and calibration,and shows a high net benefit within the critical probability range of malnutrition.It can provide reference for postoperative nutrition management of early gastric cancer patients in clinical practice.关键词
老年/胃癌/营养不良/影响因素/人格特质/低蛋白血症Key words
elderly/gastric cancer/malnutrition/influencing factor/personality trait/hypoalbuminemia引用本文复制引用
张军玲,黄娟娟,姜素峰,卢晓云,张婷..老年早期胃癌患者内镜治疗术后伴发营养不良的风险预测模型构建[J].老年医学与保健,2024,30(4):947-952,6.基金项目
江苏省中医院科技项目(Y22044) （Y22044）
