急性血糖变化和心脏手术后的早期结果:一个元分析
Shuo Chang1, Mian Xu2, Yu Wang2
1Surgery ICU, Cardiac surgery, Fuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, China.
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
|July 4, 2023
概括
高急性血糖变异 (GV) 在心脏手术患者中显著增加重大不良事件和住院死亡率的风险. 这一发现凸显了GV作为影响术后结果的关键因素.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
背景情况:
- 急性血糖变化 (GV) 是一个鲜为人知的因素,影响心脏手术后的结果.
- 现有的关于GV与早期术后结果之间的关联数据有限,需要综合.
研究的目的:
- 在接受心脏手术的患者中,系统地审查和元分析急性GV和住院结果之间的关联.
- 量化与高急性GV相关的重大不良事件 (MAE) 和住院死亡率的风险.
主要方法:
- 在主要的电子数据库 (Medline,Embase,Cochrane Library,Web of Science) 中进行了系统的文献搜索.
- 包含16,411名患者的9项队列研究被纳入了使用随机效应模型的元分析.
- 进行了敏感性和子组分析,以评估研究结果的稳定性,并探索特定的患者群体.
主要成果:
- 高急性GV与住院期间MAE风险增加显著相关 (OR:1.29,95%CI:1.15-1.45).
- 高急性GV也与更高的住院死亡风险有关 (OR:1.55,95%CI:1.15-2.09).
- 这种关联在冠状动脉旁路移植患者中更为明显,并且在调整为糖基化血红蛋白后减弱.
结论:
- 急性血糖变化是心脏手术后患者在医院治疗不良结果的重要预测因素,包括MAE和死亡率.
- 这些发现强调了心脏手术患者在术后期监测和管理GV的重要性.
- 进一步的研究可能会探索有针对性的干预措施,以减轻与高急性GV相关的风险.
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
01:22Diabetes Mellitus: Type 2 and Gestational
2.5K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
01:30Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
238
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
238