We aimed to investigate the association between sarcopenia and incidence of pneumonia after endoscopic submucosal dissection (ESD) in patients aged ≥65 years. Patients with (n= 1571) and without sarcopenia (n= 1718) who underwent ESD for gastric neoplasm were included. Propensity score matching (PSM) was performed between the groups (n= 785) at a 1:1 ratio. The primary endpoint was the effect of sarcopenia on the incidence of pneumonia after ESD. Among the included patients, 2.2% (n= 71) developed pneumonia after ESD. After PSM, the incidence rate of pneumonia was significantly higher in patients with sarcopenia than that in patients without sarcopenia (p= 0.024). Sarcopenia and age ≥73 years were significantly associated with the incidence of pneumonia (sarcopenia and age <73 years, odd ratio (OR) = 1.22 [95% confidence interval (CI): 0.46–3.22]; sarcopenia and age ≥73 years, OR = 3.92 [95% CI: 1.79–8.74]). Patients with sarcopenia had an increased risk of developing pneumonia after ESD, even after adjusting for other factors, resulting in a higher incidence of leukocytosis and a longer duration of post-ESD hospitalization. The combination of sarcopenia and age ≥73 years could be an effective predictive factor for screening high-risk groups for pneumonia after ESD.
本研究旨在探讨65岁及以上患者中，肌肉减少症与内镜黏膜下剥离术（ESD）后肺炎发生率之间的关联。研究纳入了因胃肿瘤接受ESD治疗的患者，其中肌肉减少症组1571例，非肌肉减少症组1718例。采用倾向评分匹配法以1:1比例对两组患者进行匹配（各785例）。主要研究终点为肌肉减少症对ESD后肺炎发生率的影响。在所有纳入患者中，2.2%（71例）在ESD后发生肺炎。经倾向评分匹配后，肌肉减少症患者的肺炎发生率显著高于非肌肉减少症患者（p=0.024）。肌肉减少症与年龄≥73岁均与肺炎发生率显著相关（肌肉减少症且年龄<73岁：比值比[OR]=1.22[95%置信区间(CI):0.46–3.22]；肌肉减少症且年龄≥73岁：OR=3.92[95%CI:1.79–8.74]）。即使调整其他因素后，肌肉减少症患者ESD后发生肺炎的风险仍显著增加，同时伴有更高的白细胞增多发生率和更长的术后住院时间。肌肉减少症合并年龄≥73岁可作为筛查ESD后肺炎高危人群的有效预测指标。
肿瘤(癌症)患者之家