# The assessment of autonomic nervous function in patients with gastrointestinal malignancies and its relationship with clinical characteristics

## TL;DR

This study finds that autonomic nervous function is affected in gastrointestinal cancer patients and is linked to specific clinical factors like tumor size and age.

## Contribution

The study identifies novel risk factors for autonomic dysfunction in gastrointestinal cancer patients using both questionnaire and physiological tests.

## Key findings

- Low white blood cell count and larger tumor size are risk factors for autonomic dysfunction.
- Hypertension and elevated platelet-to-albumin ratio are independent risk factors based on cardiovascular tests.
- Older age and vascular invasion are additional risk factors when combining both assessment methods.

## Abstract

The gastrointestinal tract is the organ most extensively distributed by autonomic nerves, and researches have indicated a relationship between automatic nerves and the progression of gastrointestinal cancers. This study aimed to evaluate the autonomic nervous function in patients with gastrointestinal cancer and to explore its relationship with clinical characteristics.

We employed the Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire and cardiovascular autonomic reflex tests (CARTs) to evaluate autonomic nervous function, while also conducting a thorough analysis of clinical data.

Our results showed that low white blood cell (WBC) count (OR = 0.461, 95% CI: 0.218–0.976, p = 0.043) and increased maximum tumor diameter (OR = 1.619, 95% CI: 1.025–2.555, p = 0.039) were risk factors for autonomic dysfunction according to the COMPASS-31 assessment. While hypertension (OR = 5.747, 95% CI: 1.186–27.862, p = 0.030) and elevated platelet-to-albumin ratio (PAR) (OR = 1.256, 95% CI: 1.025–1.540, p = 0.028) were identified as independent risk factors for autonomic dysfunction based on the CARTs results. Combining the findings from COMPASS-31 and CARTs revealed that older age (OR = 1.133, 95% CI: 1.015–1.264, p = 0.027) and vascular invasion (OR = 7.706, 95% CI: 1.391–42.684, p = 0.019) were also independent risk factors for autonomic dysfunction.

Our findings reveal that these specific factors related to gastrointestinal cancers significantly influence autonomic nervous function. It is essential to evaluate autonomic nervous function and its associated risk factors in patients with gastrointestinal malignancies, which provide new insights into the intervention strategies for cancer diseases.