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Huang S, Chen X, Ding H, Dong B. The relationship between low and asymmetric handgrip strength and low muscle mass: results of a cross-sectional study on health and aging trends in western China. BMC Geriatr 2024; 24:650. [PMID: 39095770 PMCID: PMC11295882 DOI: 10.1186/s12877-024-05199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/03/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE The aim was to determine the relationship between low handgrip strength (HGS) only, asymmetric HGS only, and low HGS combined with asymmetric HGS and low muscle mass in the West China Health and Aging Trends Study (WCHAT) data. STUDY DESIGN Individuals aged at least 50 years old were included in this cross-sectional study using WCHAT data. Demographic characteristics, such as age, marital status, education level, ethnicity, and drinking and smoking history, as well as chronic diseases, were recorded for all participants. The HGS of both hands was tested three times using a grip dynanometer with the participant in a standing position with arms extended, before recording the maximum value for both hands. The maximum value referred to values < 28 kg and < 18 kg for males and females, respectively. HGS ratios (non-dominant HGS/dominant HGS) of < 0.90 or > 1.10 suggest asymmetric HGS. The subjects were then allocated to the low HGS, asymmetrical HGS, and combined low and asymmetrical HGS (BOTH group) groups, and those with neither low nor asymmetric HGS (the normal group). The InBody 770 instrument was used for the analysis of muscle mass, with low muscle mass defined as a skeletal muscle mass index (SMI) of < 7.0 kg/m2 or < 5.7 kg/m2 for males and females, respectively. The associations between the different HGS groups and low muscle mass were assessed by logistic regression analysis. RESULTS The study included 1748 subjects, of whom 1272 (72.77%) were over the age of 60 years. The numbers of Han, Tibetan, and Qiang were 885 (50.63%), 217 (12.41%), and 579 (33.12%), respectively. A total of 465 individuals (26.60%) were classified as having low muscle mass, while 228 (13.04%), 536 (30.66%), and 125 (7.15%) participants were allocated to the low HGS, asymmetric HGS, and BOTH groups, respectively. The average SMI differed significantly between the normal group and the other groups (normal group vs. asymmetric HGS group vs. low HGS group vs. BOTH group: 6.627 kg/m2 vs. 6.633 kg/m2 vs. 6.492 kg/m2 vs. 5.995 kg/m2, respectively, P < 0.05). In addition, the prevalence of low muscle mass in the normal, asymmetric HGS, low HGS, and BOTH groups increased sequentially, with significant differences (normal group vs. asymmetric HGS group vs. low HGS group vs. BOTH group: 21.5% vs. 22.4% vs. 39.5% vs. 56%, respectively, P = 0.001). Further logistic regression analysis showed that the presence of low HGS (OR = 1.7, 95%CI: 1.203-2.402) and both low and asymmetric HGS (OR = 3.378, 95%CI: 2.173-5.252) were predictive of low muscle mass, with the chance being higher for the latter condition. CONCLUSION The findings suggest that although asymmetrical HGS itself does not increase the chances of low muscle mass. When low HGS and a combination of both features (low HGS combined with asymmetric HGS) is present in subjects, the chance of low muscle mass increases.
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Affiliation(s)
- Sha Huang
- Department of Geriatric, Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan, China
- West China Hospital, National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoyan Chen
- Department of Geriatric, Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan, China
- West China Hospital, National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China
| | - Huaying Ding
- Department of Geriatric, Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan, China
- West China Hospital, National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China
| | - Birong Dong
- Department of Geriatric, Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan, China.
- West China Hospital, National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China.
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Skorus-Zadęcka U, Miążek A, Zmysłowska N, Kupniewski K, Kenig J. Comorbidity assessment methods and their significance in predicting the results of treatment of older patients undergoing elective abdominal surgeries for cancer - A scoping review. Cancer Epidemiol 2024; 91:102597. [PMID: 38865796 DOI: 10.1016/j.canep.2024.102597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION The scoping review was performed to identify methods of comorbidity assessment and to evaluate their significance in predicting the results of treatment of older patients undergoing elective abdominal surgeries for cancer. MATERIALS AND METHODS Ovid MEDLINE, Embase, CENTRAL, Web of Science, ClinicalTrials.gov and European Trials Register were searched for eligible studies investigating the impact of comorbidity on various postoperative outcomes of patients aged ≥65. Findings were narratively reported. RESULTS The review identified 40 studies with a total population of 59,612 patients, using eight different methods of comorbidity assessment. The most used was Charlson Comorbidity Index (60 % of studies) and presence of specific comorbid conditions (38 %). No study provided rationale for the choice of specific comorbidity measure. Most of the included studies reported short-term results (75 %), such as postoperative complications (43 %) and mortality (18 %) as main clinical endpoint. The results were inconsistent across the studies. DISCUSSION There is still no consensus regarding the choice of comorbidity measures and their role in postoperative outcome prediction. Further efforts are needed to develop new, well-designed, more effective comorbidity assessments tools.
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Affiliation(s)
- Urszula Skorus-Zadęcka
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowski Street, Cracow 30-688, Poland.
| | - Apolonia Miążek
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowski Street, Cracow 30-688, Poland
| | - Natalia Zmysłowska
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowski Street, Cracow 30-688, Poland
| | - Kuba Kupniewski
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowski Street, Cracow 30-688, Poland
| | - Jakub Kenig
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowski Street, Cracow 30-688, Poland
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de Oliveira Bezerra MR, de Sousa IM, Miranda AL, Ferreira GMC, Chaves GV, Verde SMML, Maurício SF, da Costa Pereira JP, Gonzalez MC, Prado CM, Fayh APT. Age-adjusted Charlson comorbidity index and its association with body composition and overall survival in patients with colorectal cancer. Support Care Cancer 2024; 32:517. [PMID: 39014284 DOI: 10.1007/s00520-024-08730-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). RESEARCH METHODS AND PROCEDURES In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. RESULTS A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively). CONCLUSION The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
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Affiliation(s)
- Mara Rúbia de Oliveira Bezerra
- Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil
| | - Iasmin Matias de Sousa
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
| | - Ana Lúcia Miranda
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
- Luiz Antonio Hospital, Liga Norteriograndense Contra O Câncer, Natal, Rio Grande Do Norte, Brazil
| | - Glaucia Mardrini Cassiano Ferreira
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil
| | - Gabriela Villaça Chaves
- Department of Nutrition, Cancer Hospital II, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | | | - Silvia Fernandes Maurício
- Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Jarson Pedro da Costa Pereira
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - M Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Ana Paula Trussardi Fayh
- Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil.
- Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil.
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande Do Norte, Natal, Brazil.
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Soares JDP, Siqueira JM, Brito FDSB, Pimentel GD. A Randomized Controlled Trial on the Effects of Leucine-Supplement Combined with Nutritional Counseling on Body Composition in Mix Cancer Older Men. Nutrients 2024; 16:210. [PMID: 38257103 PMCID: PMC10818878 DOI: 10.3390/nu16020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Malnutrition and metabolic alterations of cancer cachexia are often associated with negative weight loss and muscle mass wasting. In this sense, protein supplementation can be a strategy to help counteract the loss and/or maintenance of mass in these patients. The aim of this study was to evaluate the effect of leucine supplementation on body composition in outpatients with gastrointestinal tract cancer. METHODS It was a randomized, blinded, controlled, parallel trial, performed in male patients with a cancer diagnosis of the gastrointestinal tract and appendix organs undergoing chemotherapy. All the patients were allocated to one of the protocol groups: L-leucine supplement or the control group, during 8 weeks of intervention. We evaluated the body composition through bioelectrical impedance analysis, the cancer cachexia classification, and the diet intake before and after the intervention protocol. The intention-to-treat approach was performed to predict the missing values for all patients who provide any observation data. RESULTS The patients were an average age of 65.11 ± 7.50 years old. In the body composition analysis with patients who finished all the supplementation, we observed a significant gain in body weight (61.79.9 ± 9.02 versus 64.06 ± 9.45, p = 0.01), ASMM (7.64 ± 1.24 versus 7.81 ± 1.20, p = 0.02) in the Leucine group, whereas patients in the control did not present significant variation in these parameters. There was no significant intergroup difference. While in the analysis included the patients with intention-to-treat, we found a significant increase in body weight (p = 0.01), BMI (p = 0.01), FFM (p = 0.03), and ASMM (p = 0.01) in the Leucine group. No significant intergroup differences. These results also similar among cachectic patients. CONCLUSION A balanced diet enriched with free-Leucine supplementation was able to promotes gains in body weight and lean mass in older men diagnosticated with gastrointestinal and appendix organs of digestion cancer after 8 weeks. However, the fact that most men are non-cachectic or pre-cachectic is not clear if the increase in muscle mass was due to a high intake of leucine, since no difference between groups was detected. Moreover, we know that benefits on body composition are due to adequate calorie and macronutrients consumption and that balanced feeding according to nutrition Guidelines seems crucial and must be advised during the oncological treatment.
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Affiliation(s)
- Jéssika D. P. Soares
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
| | - Jéssika M. Siqueira
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
| | - Flávia dos S. B. Brito
- Institute of Nutrition, Estadual University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil;
| | - Gustavo D. Pimentel
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
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Karakizlis H, Trudel N, Brose A, Reinisch A, Reichert M, Hecker A, Bender F, Askevold I, Rainer L, Weimer R, Krombach GA, Padberg W, Liese J. Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation. Langenbecks Arch Surg 2023; 408:103. [PMID: 36826595 PMCID: PMC9958183 DOI: 10.1007/s00423-023-02836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE The association between sarcopenia of kidney transplant recipients and outcome after kidney transplantation (KT) has not yet been fully understood and is still considered controversial. The aim of our study was to analyze the impact of pre-transplant sarcopenia on graft function, postoperative complication rates, and survival of the patients after renal transplantation. METHODS In this retrospective single-center study, all patients who underwent KT (01/2013-12/2017) were included. Demographic data, rejection rates, delayed graft function, and graft and patient survival rates were analyzed. Sarcopenia was measured in computed tomography images by the sex-adjusted Hounsfield unit average calculation (HUAC). RESULTS During the study period, 111 single KTs (38 women and 73 men) were performed. Living donor kidney transplants were performed in 48.6%. In total, 32.4% patients had sarcopenia. Sarcopenic patients were significantly older (59.6 years vs. 49.8 years; p < 0.001), had a higher body mass index (BMI = 27.6 kg/m2 vs. 25.0 kg/m2; p = 0.002), and were more likely to receive deceased donor kidneys (72.2% vs. 41.3%; p = 0.002). Interestingly, 3 years after KT, the creatinine serum levels were significantly higher (2.0 mg/dl vs. 1.5 mg/dl; p = 0.001), whereas eGFR (39.9 ml/min vs. 53.4 ml/min; p = 0.001) and graft survival were significantly lower (p = 0.004) in sarcopenic transplant recipients. Sarcopenic patients stayed in hospital significantly longer postoperatively than those who were non-sarcopenic. CONCLUSIONS At the time of kidney transplantation, sarcopenia was found to predict reduced long-term graft function and diminished graft survival after KT. The early identification of sarcopenic patients can not only enable an optimized selection of recipients, but also the initiation of pre-habilitation programs during the waiting period.
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Affiliation(s)
- H Karakizlis
- Department of Internal Medicine II, Division of Nephrology and Renal Transplantation, Justus-Liebig-University of Giessen, Giessen, Germany
| | - N Trudel
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
- Department of Diagnostic and Interventional Radiology, Marienhospital Stuttgart, Stuttgart, Germany
| | - A Brose
- Department of Radiology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - A Reinisch
- Department of General, Visceral and Oncologic Surgery, Hospital and Clinics Wetzlar, Teaching Hospital of the Justus-Liebig-University Giessen, Wetzlar, Germany
| | - M Reichert
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
| | - A Hecker
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
| | - F Bender
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
| | - I Askevold
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
| | - L Rainer
- Department of Internal Medicine II, Division of Nephrology and Renal Transplantation, Justus-Liebig-University of Giessen, Giessen, Germany
| | - R Weimer
- Department of Internal Medicine II, Division of Nephrology and Renal Transplantation, Justus-Liebig-University of Giessen, Giessen, Germany
| | - G A Krombach
- Department of Radiology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - W Padberg
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany
| | - J Liese
- Department of General, Visceral and Thoracic Surgery, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Str. 7, Giessen, Germany.
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Huang CB, Lin DD, Huang JQ, Hu W. Based on CT at the third lumbar spine level, the skeletal muscle index and psoas muscle index can predict osteoporosis. BMC Musculoskelet Disord 2022; 23:933. [PMID: 36280811 PMCID: PMC9590212 DOI: 10.1186/s12891-022-05887-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background With the increasing number of studies on osteoporosis and muscle adipose tissue, existing studies have shown that skeletal muscle tissue and adipose tissue are closely related to osteoporosis by dual-energy x-ray absorptiometry (DXA) measurement. However, few studies have explored whether the skeletal muscle and adipose tissue index measured at the lumbar spine 3 (L3) level are closely related to bone mineral density (BMD) and can even predict osteoporosis. Therefore, this study aimed to prove whether skeletal muscle and adipose tissue index measured by computed tomography (CT) images based on a single layer are closely related to BMD. Methods A total of 180 participants were enrolled in this study to obtain skeletal muscle index (SMI), psoas muscle index (PMI), subcutaneous fat index (SFI), visceral fat index (VFI), and the visceral-to-subcutaneous ratio of the fat area (VSR) at L3 levels and divide them into osteoporotic and normal groups based on the T-score of DXA. Spearman rank correlation was used to analyze the correlation between SMI, PMI, SFI, VFI, VSR, and BMD. Similarly, spearman rank correlation was also used to analyze the correlation between SMI, PMI, SFI, VFI, VSR, and the fracture risk assessment tool (FRAX). Receiver operating characteristic (ROC) was used to analyze the efficacy of SMI, PMI, SFI, VFI, and VSR in predicting osteoporosis. Results BMD of L1-4 was closely correlated with SMI, PMI, VFI and VSR (r = 0.199 p = 0.008, r = 0.422 p < 0.001, r = 0.253 p = 0.001, r = 0.310 p < 0.001). BMD of the femoral neck was only correlated with PMI and SFI (r = 0.268 p < 0.001, r = − 0.164 p-0.028). FRAX (major osteoporotic fracture) was only closely related to PMI (r = − 0.397 p < 0.001). FRAX (hip fracture) was closely related to SMI and PMI (r = − 0.183 p = 0.014, r = − 0.353 p < 0.001). Besides, FRAX (major osteoporotic fracture and hip fracture) did not correlate with VFI, SFI, and VSR. SMI and PMI were statistically significant, with the area under the curve (AUC) of 0.400 (95% confidence interval 0.312-0.488 p = 0.024) and 0.327 (95% confidence interval 0.244-0.410 p < 0.001), respectively. VFI, SFI, and VSR were not statistically significant in predicting osteoporosis. Conclusions This study demonstrated that L3-based muscle index could assist clinicians in the diagnosis of osteoporosis to a certain extent, and PMI is superior to SMI in the diagnosis of osteoporosis. In addition, VFI, SFI, and VSR do not help clinicians to diagnose osteoporosis well.
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Affiliation(s)
- Cheng-bin Huang
- grid.417384.d0000 0004 1764 2632Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000 China ,grid.268099.c0000 0001 0348 3990Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, 325000 China
| | - Duo-duo Lin
- grid.417384.d0000 0004 1764 2632The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Jian-qiang Huang
- grid.417384.d0000 0004 1764 2632The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Wei Hu
- grid.417384.d0000 0004 1764 2632Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000 China
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Effect of Heptaflourane Inhalation and Anesthesia Induction on Hemodynamics of Elderly Patients Undergoing Elective Gastrointestinal Tumor Surgery. JOURNAL OF ONCOLOGY 2022; 2022:9022614. [PMID: 35602300 PMCID: PMC9122700 DOI: 10.1155/2022/9022614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
Gastrointestinal stromal tumors (GISTs) are rare malignancies that begin in specific cells in the GI tract’s (also known as the digestive tract’s) wall. The microenvironment of gastrointestinal cancers has gotten a lot of interest in the last decade. There are various obstacles connected with providing care to individuals with gastrointestinal cancers, especially the elderly. The physiological reserves of elderly individuals are generally depleted, and comorbidities might limit treatment options and increase problems. Surgeons and anesthesiologists must be aware of the measures that must be used while dealing with this fragile population. Anesthesia is a term that refers to the use of drugs to alleviate pain during the surgery and other treatments. Anesthesia is crucial to a patient’s successful treatment and recovery. To induce and maintain general anesthesia in the operating room, inhalation anesthetics (isoflurane, halothane, nitrous oxide, sevoflurane, and desflurane, the most commonly used agents in practice today) are utilized. Inhalation anesthetics are drugs used to give general anesthesia for surgery in the operating room. Anesthetics have the potential to cause substantial cardiac depression as well as hemodynamic instability. In this study, we propose the SBWOA (spark bumper whale optimization algorithm), which is used to assess the patient’s risk before surgery. The entire experiment was run through Matlab simulations.
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