Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate...Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.展开更多
目的系统评价术前控制营养状态(CONUT)评分在胃癌术后患者预后中的价值。方法计算机检索中国知网、万方、中国生物医学文献图书馆、维普、PubMed、Web of Science、Cochrane Library、Embase数据库,收集将术前CONUT评分应用于胃癌术后...目的系统评价术前控制营养状态(CONUT)评分在胃癌术后患者预后中的价值。方法计算机检索中国知网、万方、中国生物医学文献图书馆、维普、PubMed、Web of Science、Cochrane Library、Embase数据库,收集将术前CONUT评分应用于胃癌术后患者预后的相关研究,检索时间为建库至2023年4月20日。按照纳排标准筛选文献、提取数据、质量评价后,采用RevMan 5.3和Stata 15.0软件进行Meta分析。结果共纳入17项研究,总计患者9233例。Meta分析结果显示,与CONUT低分组相比,CONUT高分组患者总生存期[HR=1.70,95%CI(1.54,1.87),P<0.01]、肿瘤特异性生存期[HR=2.55,95%CI(1.23,5.27),P=0.01]、无进展生存期[HR=1.53,95%CI(1.29,1.82),P<0.01]更差。同时,CONUT评分与并发症[OR=2.10,95%CI(1.53,2.90),P<0.01]、神经浸润[OR=1.54,95%CI(1.02,2.32),P=0.04]、死亡率[OR=2.24,95%CI(1.25,4.01),P<0.01]、T3/4[OR=2.06,95%CI(1.73,2.46),P<0.01]、N2/3[OR=1.76,95%CI(1.51,2.05),P<0.01]、Ⅲ期[OR=1.62,95%CI(1.39,1.90),P<0.01]显著相关,但与肿瘤分化无关[OR=0.88,95%CI(0.75,1.04),P=0.13]。结论术前CONUT评分与胃癌患者术后并发症和临床病理参数相关,是患者预后的独立预测指标。展开更多
文摘Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.
