Sarcopenia and nutritional status are associated with Severe Postoperative Complications in Gastric Cancer Patients: A Multicenter Study

Abstract

Purpose The aim of this study was to determine the risk of severe postoperative complications (SPCs) in patients with gastric cancer and to construct a nomogram based on independently related factors to identify high-risk patients.Methods We retrospectively analyzed 297 consecutive patients undergoing gastrectomy in this multicenter study. Sarcopenia was diagnosed by preoperative computed tomography of the L3 skeletal muscle area. Nutritional status was assessed according to the Global Leadership Initiative on Malnutrition criteria. According to the Clavien–Dindo classification system, SPCs were classified as C-D Grade ≥ IIIa. A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of SPCs.Results Of the 297 patients analyzed in this study, 86 (28.96%) were diagnosed with malnutrition, 55 (18.52%) were diagnosed with sarcopenia, and 24 (8.08%) were diagnosed with SPCs. Patients who developed SPCs had longer hospital stays (SPCs vs. non-SPCs: 23 vs. 11 days, P < 0.001) and higher hospitalization expenses (SPCs vs. non-SPCs: 121456¥ vs. 72012¥, P < 0.001) than those who did not. Logistic analysis revealed that malnutrition (P < 0.001), sarcopenia (P = 0.017), combined resection (P = 0.028), and duodenostomy (P = 0.001) independently predicted the occurrence of SPCs. The nomogram exhibited good discrimination, with a discriminant consistency index of 0.822, and the calibration was also excellent.Conclusions Sarcopenia, malnutrition, combined resection and duodenostomy are independent predictors of SPCs. Our nomogram exhibited good discrimination and was practical for identifying patients at high risk of SPCs.