Akimasa Fukuta1, Takashi Saito2, Shunsuke Murata3, Daisuke Makiura4, Junichiro Inoue4, Maho Okumura1, Yoshitada Sakai5, Rei Ono6. 1. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan. 2. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan; Division of Rehabilitation, Kobe University Hospital, Kobe, Japan. 3. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan; Japan Society for the Promotion of Science, Tokyo, Japan. 4. Division of Rehabilitation, Kobe University Hospital, Kobe, Japan. 5. Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 6. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan. Electronic address: Ono@phoenix.kobe-u.ac.jp.
Abstract
OBJECTIVES: The aim of the present study was to investigate the impact of preoperative cachexia on postoperative length of stay (LOS) in elderly patients with gastrointestinal cancer. METHODS: This prospective cohort study enrolled 98 patients (≥60 y of age) with gastric or colorectal cancer who were scheduled to undergo curative surgery and were categorized as either having cachexia or as being in a non-cachexia group. The definition of cachexia was patients with >5% loss of stable body weight over the previous 6 mo, a body mass index (BMI) <20 kg/m2 and ongoing weight loss >2%, or sarcopenia and ongoing weight loss >2%. Multivariable Poisson regression analysis was performed with postoperative LOS as the dependent variable and the presence of cachexia as the independent variable, and age, sex, Eastern Cooperative Oncology Group performance status, education, cancer type, clinical stage, surgical approach, and the Charlson Comorbidity Index as confounding variables. RESULTS: Twenty-two patients (22.4%) were diagnosed with cachexia. Postoperative LOS was 17.1 ± 8.7 d in the non-cachexia group and 20.6 ± 10.8 d in the cachexia group. Multivariable Poisson analysis showed that preoperative cachexia was significantly associated with prolonged postoperative LOS after adjustment (2.41 d; 95% confidence interval, 0.28 to 4.55; P = 0.027). CONCLUSIONS: Our results suggested that preoperative cachexia prolongs postoperative LOS in elderly patients with gastrointestinal cancer, implying that cachexia should be assessed and treated before surgery.
OBJECTIVES: The aim of the present study was to investigate the impact of preoperative cachexia on postoperative length of stay (LOS) in elderly patients with gastrointestinal cancer. METHODS: This prospective cohort study enrolled 98 patients (≥60 y of age) with gastric or colorectal cancer who were scheduled to undergo curative surgery and were categorized as either having cachexia or as being in a non-cachexia group. The definition of cachexia was patients with >5% loss of stable body weight over the previous 6 mo, a body mass index (BMI) <20 kg/m2 and ongoing weight loss >2%, or sarcopenia and ongoing weight loss >2%. Multivariable Poisson regression analysis was performed with postoperative LOS as the dependent variable and the presence of cachexia as the independent variable, and age, sex, Eastern Cooperative Oncology Group performance status, education, cancer type, clinical stage, surgical approach, and the Charlson Comorbidity Index as confounding variables. RESULTS: Twenty-two patients (22.4%) were diagnosed with cachexia. Postoperative LOS was 17.1 ± 8.7 d in the non-cachexia group and 20.6 ± 10.8 d in the cachexia group. Multivariable Poisson analysis showed that preoperative cachexia was significantly associated with prolonged postoperative LOS after adjustment (2.41 d; 95% confidence interval, 0.28 to 4.55; P = 0.027). CONCLUSIONS: Our results suggested that preoperative cachexia prolongs postoperative LOS in elderly patients with gastrointestinal cancer, implying that cachexia should be assessed and treated before surgery.