糖尿病是术后并发症的风险因素,在关节镜旋转手腕修复后
Patricia E Cerri-Droz1, Kenny Ling2, Samuel Aknoukh2
1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
JSES international
|November 16, 2023
概括
经过关节镜旋转手套修复 (aRCR) 的糖尿病患者面临更高的风险. 非胰岛素依赖型糖尿病增加了败血症风险,而胰岛素依赖型糖尿病与肺炎,再入院和ARCR后更长的通风相关.
科学领域:
- 整形外科手术 整形外科手术
- 糖尿病学 糖尿病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 糖尿病患者在关节镜旋转手腕修复 (aRCR) 后患上术后并发症的风险增加.
- 了解非胰岛素依赖性糖尿病 (NIDDM) 和胰岛素依赖性糖尿病 (IDDM) 的特定风险对于患者护理至关重要.
- 为了调查这些30天的术后并发症,我们使用了一个大型的国家数据库.
研究的目的:
- 为了确定与aRCR后的NIDDM和IDDM相关的30天术后并发症.
- 确定接受aRCR的糖尿病患者并发症的独立风险因素.
- 为了比较糖尿病患者和非糖尿病患者之间的并发症率.
主要方法:
- 利用美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库从2015年至2020年.
- 将患者分类为NIDDM,IDDM和没有糖尿病的队列.
- 进行了调整以人口统计和并发症为准的多变量分析,以确定独立的风险因素.
主要成果:
- NIDDM是败血症的一个独立风险因素 (OR,2.77;P = .047).
- IDDM是肺炎 (OR,2.49;P = .023), readmission (OR,1.617;P = .003),心肌梗塞 (OR,0.50;P = .048) 和长时间通风 (>48小时) (OR,5.63;P = .015) 的独立危险因素.
- 无论是NIDDM还是IDDM,都与更高的BMI,ASA类≥3,高血压,慢性肺炎,出血障碍和手术前感染 (P < .001) 相关.
结论:
- 在aRCR之后,NIDDM独立地增加了败血症的风险.
- IDDM独立地增加了肺炎,再入院,心肌梗塞和aRCR后长时间通风的风险.
- 这些发现突出了在aRCR后不同类型糖尿病的不同术后并发症概况.
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