保健医学研究与实践2025，Vol.22Issue(12)：91-97,7.DOI:10.11986/j.issn.1673-873X.2025.12.14
食管癌患者术后衰弱变化轨迹及影响因素研究
Postoperative frailty change trajectories and influencing factors in patients with esophageal cancer
摘要
Abstract
Objective To analyze the postoperative frailty change trajectories in patients with esophageal cancer,understand their progression patterns,and explore the influencing factors.Methods A total of 120 esophageal cancer patients admitted to Jiangsu Cancer Hospital from October 2021 to June 2024 were enrolled.The Clinical Frailty Scale(CFS)was used to as-sess their frailty status preoperatively and at 1 month,3 months,and 6 months postoperatively.A growth mixture model(GMM)was employed for change trajectory analysis.Clinical data were compared between patients with persistent or pro-gressive frailty and those with no frailty or frailty improvement.A logistic multivariate model was used to analyze factors in-fluencing the persistence or progression of frailty.Results Using a CFS level≥5 as the criterion for frailty,the incidence of frailty was highest at 1 month postoperatively and then gradually declined.ANOVA results showed that frailty levels signif-icantly increased at 1 month postoperatively,subsequently eased,but had not returned to baseline by 6 months postopera-tively(P<0.001).GMM analysis indicated that the 3C model with free estimation was the optimal model for predicting frailty change trajectories.Model categories 1,2,and 3 were identified as persistent frailty,improved frailty,and progres-sive frailty,respectively,comprising 11(9.20%),81(67.50%),and 28(23.30%)patients.Multivariate analysis demon-strated that age≥65 years,living alone,clinical stage Ⅲa-Ⅲb,receiving neoadjuvant therapy,postoperative chemoradio-therapy,and having nutritional risk were independent risk factors for persistent or progressive postoperative frailty in esoph-ageal cancer patients(P<0.05).Conclusion The incidence of postoperative frailty is high in esophageal cancer patients,manifesting three distinct trajectories:persistence,improvement,and progression.The persistence and progression of frail-ty are influenced by multiple factors,including patient age,living status,clinical stage,treatment strategy,and nutritional status.Clinical attention should be paid to the change trajectories of postoperative frailty and its influencing factors.Individ-ualized management strategies should be developed based on an integrated biopsychosocial medical model to improve patient prognosis.关键词
食管癌/衰弱/临床衰弱量表/变化轨迹/营养风险筛查/影响因素Key words
Esophageal cancer/Frailty/Clinical Frailty Scale/Change trajectory/Nutritional risk screening/Influencing factors分类
医药卫生引用本文复制引用
钟梦瑶,薛蒙,魏玮,刘腊根,夏文杰,夏红梅,聂嘉蕊..食管癌患者术后衰弱变化轨迹及影响因素研究[J].保健医学研究与实践,2025,22(12):91-97,7.基金项目
国家自然科学基金项目(82003106). （82003106）
