Changes of resting energy metabolism in perioperative elderly patients with gastrointestinal tumor

Objective To observe the changing rules of resting energy metabolism(REM) in perioperative elderly patients with gastrointestinal tumor. Methods Seventy-three elderly patients with gastrointestinal tumor at the age of 65-80 years were included in this control study.Their REM was assayed before and 3-5d and 7-10d after surgery by indirect calorimetry(MedGem).Their body height,body weight,body mass index(BMI),biochemical indications,albumin and C-creative protein(CRP) level were measured.Their nutritional status was tested following the mini nutritional assessment(MNA) score. Results No significant difference was found in REE among the patients before and 3-5d after surgery(4 869.07±432.31)kJ/d vs(4 629.10±421.68)kJ/d in males,(4 062.12 ±502.49)kJ/d vs(3 892.63± 488.29)kJ/d in females,P>0.05).The REE was significantly lower in male and female patients 7-10d after surgery than before and 3-5d after surgery(3 443.15±385.02)kJ/d vs(4 340.22±418.82)kJ/d and(4 600.47± 434.45)kJ/d,(4 137.11±347.21)kJ/d vs(5 012.36±455.15)kJ/d and(5 091.66±421.89)kJ/d in male patients,and(3 766.56±388.08)kJ/d vs(4 180.08±305.86)kJ/d and(4 477.11±416.47)kJ/d in female patients,(P<0.05).The hemoglobin level and total number of lymphocytes were significantly lower in male patients 3-5d and 7-10d after surgery than before surgery(131.07±24.18)g/L and(125.08±23.82)g/L vs(147.79±14.82)g/L,(1 363.95±570.76)/ml and(1 316.78±589.66)/ml vs(1 667.98±600.15)/ml,(P<0.05).The BMI and MNA score were significantly lower in male and female patients after surgery than before surgery(22.02±2.07)kg/m² and(21.45±2.89)kg/m² vs(23.11±2.11)kg/m²,(20.77±2.08)kg/m² and(20.06±2.16)kg/m² vs(21.04±1.99)kg/m² in male patients,20.58±6.22 and 20.92±8.15 vs 22.98±5.48,20.33±9.16 and 19.98±6.88 vs 23.12±6.26 in female patients,(P<0.05). Conclusion The REM of elderly patients with gastrointestinal tumor tends to decrease after surgery,which may be related with the decreased BMI,hemoglobin,total number of lymphocytes and MNA score.