Effect of Preoperative Malnutrition Based on Albumin and BMI on Hepatocellular Carcinoma Surgery and Prediction of Risk Factors of Complications

作者全名："Jin, Weiqiang; Jiang, Shiming; Chen, Anke; Chen, Yong"

作者地址："[Jin, Weiqiang; Jiang, Shiming; Chen, Anke; Chen, Yong] Chongqing Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Chen, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：JOURNAL OF GASTROINTESTINAL CANCER

ESI学科分类：　

WOS号：WOS:001132747000002

JCR分区：Q4

影响因子：1.6

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Review; Early Access

关键词：Malnutrition; Albumin; Body mass index; Hepatocellular carcinoma

摘要："Background To investigate the correlation between preoperative malnutrition and perioperative variables in patients with hepatocellular carcinoma (HCC) and to analyze the risk factors of complications after HCC resection.Methods All patients who underwent hepatectomy because of HCC in the First Affiliated Hospital of Chongqing Medical University from June 1, 2018, to December 1, 2021, were analyzed retrospectively. Preoperative malnutrition was defined as body mass index (BMI) < 18.5 kg/m2 or serum albumin level < 3.5 g/dL within 30 days before operation.Results A total of 415 patients with HCC hepatectomy were included, and 75 (18.1%) were classified as malnutrition group. In the malnutrition group, blood loss (662.1 +/- 748.1 VS 404.6 +/- 681.9, P = 0.002), transfusion rate (36.0% VS 13.5%, P < 0.001), postoperative hospital stays (13.3 +/- 9.6 VS 10.1 +/- 4.2, P < 0.001), 30-day postoperative mortality (4.0 VS 0.6%, P = 0.043), complications rate (68% VS 34.8%, P < 0.001), and severe complication rate (17.3% VS 2.4%, P < 0.001) were significantly higher than those in the well-nourished group. Multivariate analysis showed that age (HR 1.037, 95% CI 1.015-1.059, P = 0.001), preoperative malnutrition (HR 2.933, 95% CI 1.515-5.679, P = 0.001), simultaneous cholecystectomy (HR 2.004, 95% CI 1.168-3.440, P = 0.012), cirrhosis (HR 4.997, 95% CI 2.864-8.718, P < 0.001), and transfusion (HR 5.166, 95% CI 2.272-11.748, P < 0.001) were independent risk factors for postoperative complications. In addition, preoperative malnutrition (HR 8.209, 95% CI 2.711-24.864, P < 0.001) and operation time (HR 1.088, 95% CI 1.003-1.103, P = 0.004) were independent risk factors for severe complications.Conclusion Preoperative malnutrition can adversely affect the outcome of HCC resection. For patients with advanced age, cirrhosis, and malnutrition, preoperative planning is very important, and we should be more careful during the operation to avoid transfusion caused by bleeding and not to carry out preventive cholecystectomy, which are helpful to reduce the occurrence of postoperative complications."

基金机构：National Natural Science Foundation of China [81270559]

基金资助正文：This study was supported by the National Natural Science Foundation of China (No 81270559).