Impact of bundle care on quality of life and nutrition after transarterial chemoembolization

doi:10.4251/wjgo.v18.i6.117627

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Jun 15, 2026; 18(6): 117627
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.117627

Table 1 Baseline and disease-related data of the two groups before nursing care, n (%)

Variable	Grouping	Subjects of study (n = 80)	Control group (n = 40)	Test group (n = 40)	χ²/Z/t	P value
Age, mean ± SD		60.95 ± 8.22	59.97 ± 8.21	61.93 ± 8.19	0.134	0.863
Sex	Male	67 (83.75)	34 (85.00)	33 (82.50)	0.092	0.762
Sex	Female	13 (16.25)	6 (15.00)	7 (17.50)	0.092	0.762
BMI, mean ± SD		21.57 ± 2.91	21.68 ± 2.58	21.47 ± 3.26	0.365	0.684
Smoking history	No	26 (32.5)	10 (25.0)	16 (40.0)	2.051	0.152
Smoking history	Yes	54 (67.5)	30 (75.0)	24 (60.0)	2.051	0.152
Drinking history	No	27 (33.75)	11(27.50)	16 (40.0)	1.398	0.237
Drinking history	Yes	53 (66.25)	29 (72.50)	24 (60.0)	1.398	0.237
CCI grouping	0	69 (86.25)	36 (90.0)	33 (82.5)	4.273	0.118
	1	4 (5.0)	0 (0.0)	4 (10.0)
	2	7 (8.75)	4 (10.0)	3 (7.5)
	≥ 3	0 (0.0)	0 (0.0)	0 (0.0)
Hepatitis history	No	6 (7.5)	1 (2.5)	5 (12.5)	3.394	0.335
	Hepatitis B	66 (82.5)	34 (85.0)	32 (80.0)
	Hepatitis C	6 (7.5)	4 (10.0)	2 (5.0)
	Other	2 (2.5)	1 (2.5)	1 (2.5)
Child-Pugh class	A	70 (87.5)	34 (85.0)	36 (90.0)	0.457	0.499
Child-Pugh class	B	10 (12.5)	6 (15.0)	4 (10.0)	0.457	0.499
TACE times	-	2.00 (1.00-4.00)	2.50 (1.00-4.00)	2.00 (1.00-4.75)	0.832	0.423
	1-2	42 (52.5)	20 (50.0)	22 (55.0)	0.223	0.894
	3-5	27 (33.75)	14 (35.0)	13 (32.5)	-	-
	> 5	11 (13.75)	6 (15.0)	5 (12.5)	-	-
TACE embolization type	cTACE	61 (76.25)	29 (72.5)	32 (80.0)	0.621	0.431
TACE embolization type	DEB-TACE	19 (23.75)	11 (27.5)	8 (20.0)	0.621	0.431

BMI: Body mass index; CCI: Charlson comorbidity index; TACE: Transarterial chemoembolization; cTACE: Conventional transarterial chemoembolization; DEB-TACE: Drug-eluting bead transarterial chemoembolization.

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Table 2 Comparison of post-embolization syndrome before nursing care between the two groups, n (%)

Variable	Grouping	Subjects of study (n = 80)	Control group (n = 40)	Test group (n = 40)	χ²/Z/t	P value
Pain intensity (NRS)	-	1.50 (1.00-3.00)	2.50 (1.00-3.00)	1.00 (0-2.75)	1.645	0.125
	None (0)	19 (23.75)	7 (17.5)	12 (30.0)	4.336	0.114
	Mild (1-3)	49 (61.25)	24 (60.0)	25 (62.5)
	Moderate (4-6)	12 (15.0)	9 (22.5)	3 (7.5)
	Severe (7-10)	0 (0.0)	0 (0.0)	0 (0.0)
Nausea severity	0	47 (58.75)	24 (60.0)	23 (57.5)	0.065	0.996
	I	6 (7.5)	3 (7.5)	3 (7.5)
	II	23 (28.75)	11 (27.5)	12 (30.0)
	III	4 (5.0)	2 (5.0)	2 (5.0)
Vomiting severity	0	61 (76.25)	34 (85.0)	27 (67.5)	3.403	0.182
	I	9 (11.25)	3 (7.5)	6 (15.0)
	II	10 (12.5)	3 (7.5)	7 (17.5)
	III	0 (0.0)	0 (0.0)	0 (0.0)
Fever occurrence	No	54 (67.5)	30 (75.0)	24 (60.0)	2.051	0.152
Fever occurrence	Yes	26 (32.5)	10 (25.0)	16 (40.0)	2.051	0.152

NRS: Numerical Rating Scale.

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Table 3 Comparison of laboratory indicators before nursing care between the two groups, mean ± SD

Variable	Subjects of study (n = 80)	Control group (n = 40)	Test group (n = 40)	Z/t	P value
Hemoglobin (g/dL)	114.24 ± 20.61	113.7 ± 22.84	114.79 ± 18.59	0.057	0.954
Albumin (g/L)	33.47 ± 3.49	33.74 ± 3.24	33.21 ± 3.76	0.563	0.576
NLR	5.34 ± 2.70	5.57 ± 2.50	5.12 ± 3.92	0.584	0.566
PLR	140.45 (87.80-218.83)	146.55 (94.85-193.83)	126.95 (75.95-260.45)	0.388	0.685
AST (U/L)	51.00 (39.25-94.00)	51.00 (38.50-70.75)	61.00 (40.50-119.75)	0.815	0.422
ALT (U/L)	63.00 (43.25-112.00)	61.00 (43.25-114.25)	65.00 (35.75-103.50)	0.183	0.852
Total bilirubin (g/dL)	18.40 (13.67-26.72)	18.50 (14.83-30.00)	17.70 (12.02-26.72)	1.134	0.301

NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

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Table 4 Comparison of emotional and sleep status before nursing care between the two groups, n (%)

Variable	Grouping	Subjects of study (n = 80)	Control group (n = 40)	Test group (n = 40)	χ²/Z/t	P value
HADS-A	-	5.79 ± 2.32	6.29 ± 2.21	5.29 ± 2.35	1.628	0.112
	No anxiety (≤ 7)	60 (75.0)	29 (72.5)	31 (77.5)	0.267	0.606
	Anxiety (8-21)	20 (25.0)	11 (27.5)	9 (22.5)	0.267	0.606
HADS-D	-	6.00 (4.25-8.00)	7.00 (5.00-8.00)	5.00 (3.25-7.75)	1.865	0.063
	No depression (≤ 7)	57 (71.25)	27 (67.5)	30 (75.0)	0.549	0.459
	Depression (8-21)	23 (28.75)	13 (32.5)	10 (25.0)	0.549	0.459
PSQI	-	6.00 (5.00-7.00)	5.50 (5.00-7.00)	6.00 (5.00-9.75)	0.604	0.514
	Very good (0-5)	37 (46.25)	20 (50.0)	17 (42.5)	4.688	0.196
	Fairly good (6-10)	36 (45.0)	19 (47.5)	17 (42.5)
	Average (11-15)	3 (3.75)	1 (2.5)	2 (5.0)
	Poor (16-21)	4 (5.0)	0 (0.0)	4 (10.0)

HADS-A: Hospital Anxiety and Depression Scale-Anxiety; HADS-D: Hospital Anxiety and Depression Scale-Depression; PSQI: Pittsburgh Sleep Quality Index.

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Table 5 Comparison of nutritional status before nursing care between the two groups, n (%)

Variable	Subjects of study (n = 80)	Control group (n = 40)	Test group (n = 40)	χ²/t	P value
PG-SGA total score, mean ± SD	6.73 ± 3.57	6.96 ± 3.49	6.50 ± 3.70	0.513	0.569
Good nutritional status (PG-SGA-A)	13 (16.25)	6 (15.0)	7 (17.5)	0.245	0.885
Suspected or moderate malnutrition (PG-SGA-B)	39 (48.75)	19 (47.5)	20 (50.0)	-	-
Severe malnutrition (PG-SGA-C)	28 (35.0)	15 (37.5)	13 (32.5)	-	-

PG-SGA: Patient-Generated Subjective Global Assessment.

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Table 6 Correlation analysis of nutritional status and indicators before nursing care in hepatocellular carcinoma patients treated with transarterial chemoembolization

Variable	PG-SGA score
Variable	r value	P value
Hemoglobin (g/dL)	-0.098	0.162
ALB (g/L)	-0.107	0.127
NLR	0.073	0.304
PLR	0.107	0.128
AST (U/L)	0.110	0.116
ALT (U/L)	0.162	0.019
Total bilirubin (g/dL)	0.241	< 0.001
Pain	0.304	< 0.001
Nausea	0.531	< 0.001
Vomiting	0.456	< 0.001
Fever	0.118	0.092
HADS-A score	0.410	< 0.001
HADS-D score	0.358	< 0.001
PSQI score	0.296	< 0.001

ALB: Albumin; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HADS-A: Hospital Anxiety and Depression Scale-Anxiety; HADS-D: Hospital Anxiety and Depression Scale-Depression; PSQI: Pittsburgh Sleep Quality Index; PG-SGA: Patient-Generated Subjective Global Assessment.

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Table 7 Comparison of patient-generated subjective global assessment scores and anxiety, depression status after different nursing interventions between the two groups, n (%)

Group/indicator	Post-nursing		χ²/Z/t	P value
Group/indicator	Control group (n = 40)	Test group (n = 40)	χ²/Z/t	P value
PG-SGA score	4.46 ± 2.13^a	1.86 ± 0.89^b	-4.459	0.000
HADS-A
Score	4.25 ± 2.03^a	0.36 ± 0.49^b	-6.265	0.000
No anxiety	36 (90.00)^a	40 (100.00)^b	4.211	0.040
Anxiety	4 (10.00)	0 (0.00)	-	-
HADS-D
Score	5.00 (4.00, 5.00)^a	0.00 (0.00, 1.00)^b	-6.245	0.000
No depression	34 (85.00)^a	39 (97.50)^b	3.914	0.048
Depression	6 (15.00)	1 (2.50)	-	-

^aP < 0.05 compared to the control group before nursing.

^bP < 0.05 compared to the same group before nursing.

HADS-A: Hospital Anxiety and Depression Scale-Anxiety; HADS-D: Hospital Anxiety and Depression Scale-Depression; PG-SGA: Patient-generated subjective global assessment.

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Table 8 Comparison of post-embolization syndrome after different nursing interventions between the two groups, n (%)

Group/indicator	Post-nursing		χ²/Z/t	P value
Group/indicator	Control group (n = 40)	Test group (n = 40)	χ²/Z/t	P value
NRS score	0.00 (0.00-0.00)^a	0.00 (0.00-0.00)^b	-0.856	0.392
Nausea symptoms			3.550	0.314
0	35 (87.5)^a	39 (97.5)^b
1	2 (5.0)	1 (2.5)
2	2 (5.0)	0 (0.0)
3	1 (2.5)	0 (0.0)
Vomiting symptoms			1.387	0.709
0	36 (90.0)	38 (95.0)^b
1	1 (2.5)	1 (2.5)
2	2 (5.0)	1 (2.5)
3	1 (2.5)	0 (0.0)

^aP < 0.05 compared to the control group before nursing.

^bP < 0.05 compared to the experimental group before nursing.

NRS: Numerical Rating Scale.

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Table 9 Comparison of changes in laboratory indicators after different nursing interventions between the two groups, mean ± SD

Group/indicator	Post-nursing		Z/t	P value
Group/indicator	Control group (n = 40)	Test group (n = 40)	Z/t	P value
BMI (kg/m²)	21.67 ± 2.63	24.24 ± 2.45^a	4.522	0.000
Hemoglobin (g/dL)	121.75 ± 21.49	121.57 ± 17.27	0.034	0.973
Albumin (g/L)	35.60 ± 4.87	38.33 ± 4.09^a	2.714	0.008

^aP < 0.05 compared to the experimental group before nursing.

BMI: Body mass index.

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Citation: Zhao GY, Yu J. Impact of bundle care on quality of life and nutrition after transarterial chemoembolization. World J Gastrointest Oncol 2026; 18(6): 117627
URL: https://www.wjgnet.com/1948-5204/full/v18/i6/117627.htm
DOI: https://dx.doi.org/10.4251/wjgo.v18.i6.117627

Zhao GY, Yu J. Impact of bundle care on quality of life and nutrition after transarterial chemoembolization. World J Gastrointest Oncol 2026; 18(6): 117627 [DOI: 10.4251/wjgo.v18.i6.117627]

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