Abstract:

Objective　To explore the predictive value of geriatric nutritional risk index (GNRI) combined with prealbumin (PA) for postoperative complications in elderly patients with liver cancer. Methods　A total of 82 elderly patients with liver cancer admitted to Weihai Central Hospital from January 2020 to January 2022 were selected, including 42 females and 40 males, with an age of (75.68±7.85) years old. The GNRI value and PA level were detected. The patients were divided into a complication group and a non-complication group according to whether the postoperative complications occurred. The predictive efficacies of GNRI and PA on postoperative complications in elderly patients with liver cancer were analyzed. Independent sample t test, χ² test, and logistic regression analysis were used, and the receiver operating characteristic curve (ROC) was drawn. Results　There were 16 cases (19.51%) of postoperative complications in the 82 elderly patients, including 10 cases of postoperative bleeding, 2 cases of infection, 2 cases of bile leakage, and 2 cases of chylous fistula. There were no statistically significant differences in the gender, smoking, diabetes, hyperlipidemia, age, creatinine, γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) between the two groups (all P>0.05). The GNRI value [(90.25±10.52)] in the complication group was lower than that in the non-complication group [(100.52±19.65)], and the PA level [(168.52±19.62) mg/L] was higher than that in the non-complication group [(69.25±10.35) mg/L], with statistically significant differences (t=2.015, P=0.047; t=28.233, P<0.001). Logistic multivariate regression analysis showed that decreased GNRI and increased PA were risk factors for postoperative complications in elderly patients with liver cancer (both P<0.001). The ROC analysis showed that the areas under curves (AUCs) of GNRI, PA, and their combination in the prediction of postoperative complications in elderly patients with liver cancer were 0.837, 0.858, and 0.954, respectively, and the AUC of combined detection was higher than that of single index. Conclusion　GNRI and PA both have a certain predictive efficacy for postoperative complications in elderly patients with liver cancer, and the combined detection has a higher predictive efficacy.

Key words:

 , Liver cancer in the elderly, Postoperative complications, Geriatric nutritional risk index, Prealbumin, Predictive efficacy

摘要：

目的　探究老年营养风险指数（GNRI）联合前清蛋白（PA）对老年肝癌患者术后并发症的预测价值。方法　选取2020年1月至2022年1月威海市中心医院收治的老年肝癌患者82例，其中男40例、女42例，年龄（75.68±7.85）岁，行GNRI值检查，检测PA，并根据患者术后是否发生并发症分为并发症组和无并发症组，分析GNRI、PA对老年肝癌患者术后并发症的预测效能。采用独立样本t检验、χ²检验、logistic多因素回归分析，绘制受试者工作特征曲线（ROC）。结果　82例原发性肝癌患者中术后发生并发症16例（19.51%），其中术后出血10例，感染、胆漏、乳糜瘘各2例。两组性别、吸烟、糖尿病、高脂血症、年龄、肌酐、γ-谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）对比差异均无统计学意义（均P>0.05）；并发症组GNRI［（90.25±10.52）］低于无并发症组［（100.52±19.65）］，PA［（168.52±19.62）mg/L］高于无并发症组［（69.25±10.35）mg/L］，差异均有统计学意义（t=2.015、28.233，P=0.047、<0.001）。logistic多因素回归分析结果显示，GNRI降低、PA升高均为老年肝癌患者术后发生并发症的危险因素（均P<0.001）。ROC分析显示，GNRI、PA以及两者联合预测老年肝癌患者术后并发症的曲线下面积（AUC）分别为0.837、0.858、0.954，联合检测AUC高于单一指标。结论　GNRI、PA对老年肝癌患者术后并发症具有一定的预测效能，且联合检测的预测效能较高。

关键词:

老年肝癌, 术后并发症, 老年营养风险指数, 前清蛋白, 预测效能