Preoperative Muscle Strength Is a Predictor of Outcomes After Esophagectomy

被引:10
作者
Colcord, Madison E. [1 ]
Benbow, Jennifer H. [1 ]
Trufan, Sally [2 ]
Gower, Nicole L. [1 ]
Byrne, Meredith E. [3 ]
Shea, Reilly E. [1 ]
Watson, Michael D. [4 ]
Hill, Joshua S. [4 ]
Squires, M. Hart [4 ]
Salo, Jonathan C. [4 ]
机构
[1] Atrium Hlth, Carolinas Med Ctr, Levine Canc Inst, LCI Res Support,Clin Trials Off, Charlotte, NC USA
[2] Atrium Hlth, Carolinas Med Ctr, Levine Canc Inst, Dept Biostat, Charlotte, NC USA
[3] Atrium Hlth, Carolinas Med Ctr, Dept Clin Nutr, Charlotte, NC USA
[4] Atrium Hlth, Carolinas Med Ctr, Levine Canc Inst, Div Surg Oncol,Dept Surg, 1021 Morehead Med Dr, Charlotte, NC 28204 USA
关键词
Hand-grip strength; Sarcopenia; Esophagectomy; SKELETAL-MUSCLE; CANCER; SARCOPENIA; CHEMOTHERAPY; PROGRESSION; CACHEXIA; HEALTH;
D O I
10.1007/s11605-021-05183-y
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Sarcopenia, loss of muscle mass and strength, has been associated with more frequent complications after esophagectomy. This study compared hand-grip strength, muscle mass, and intramuscular adipose tissue as predictors of postoperative outcomes and mortality after esophagectomy. Methods Minimally invasive esophagectomy was performed on 175 patients with esophageal cancer. Skeletal muscle index and skeletal muscle density were derived from preoperative CTs. Hand-grip strength was measured using dynamometer. Univariate and multivariable analyses were performed. Results Preoperative hand-grip strength was normal in 91 (52%), intermediate in 43 (25%), and weak in 41 (23%) patients. Hand-grip strength was significantly correlated with both skeletal muscle index and skeletal muscle density. Postoperative pneumonia occurred in 8/41 (20%) patients with weak strength compared to 4/91 (4%) with normal strength (p = 0.006; Cochran-Armitage Test). Prolonged postoperative ventilation occurred in 11/41 (27%) patients with weak strength compared to 11/91 (12%) with normal strength (p = 0.036). Median length of stay was 9 days in patients with weak strength compared to 7 days for those with normal strength (p = 0.005; Kruskal-Wallis Test). Discharge to non-home location occurred in 15/41 (37%) with weak strength compared to 8/91 (9%) with normal strength (p < 0.001). Postoperative mortality at 90 days was 4/41 (10%) with weak strength compared with no mortalities (0/91) in the normal strength group (p = 0.004). Mortality at 1 year was 18/39 (46%) in patients with weak strength compared to 6/81 (7%) with normal strength, among 158 patients with 1-year follow-up (p < 0.001). Conclusions Preoperative hand-grip strength was found to be a powerful predictor of postoperative pneumonia, length of stay, discharge to non-home location, and mortality after esophagectomy.
引用
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页码:3040 / 3048
页数:9
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