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血红蛋白A1c超出8%的更严格的血糖控制是否会改善腰椎手术的结果? 一个MSSIC研究

Edvin Telemi¹, Tarek R Mansour¹, Matthew Brennan²

¹Department of Neurosurgery, Center for Health Services Research, Henry Ford Health, Detroit, Michigan, USA.

|January 19, 2024

概括

在脊椎手术前将血红蛋白A1c (HbA1c) 降低到8%以下可能不会显著减少并发症. 虽然存在一些好处,但随着HbA1c水平进一步下降,风险降低会减少.

科学领域:

脊柱外科手术的结果
糖尿病管理糖尿病管理
患者安全患者安全

背景情况:

糖尿病增加了不良术后结果的风险.
血糖控制对于管理手术并发症至关重要.

研究的目的:

评估手术前血红蛋白A1c (HbA1c) 低于8%的水平是否能改善选择性腰椎手术后的结果.
确定在经过脊柱手术的糖尿病患者有意义地降低风险的门.

主要方法:

来自密歇根脊柱外科改善协作注册表 (2018-2021) 的患者数据分析.
包括接受选择性腰椎手术的患者.
主要结局:停留时间和不良事件的发生. 二次结果:患者满意度,功能改善,疼痛和恢复工作.

主要成果:

升高的HbA1c水平与更高的尿路保留风险,更长的住院时间和整体并发症增加相关.
患有HbA1c超过7.5%或7%的患者出现了更多的并发症.
术前HbA1c超过值与较低的身体功能和生活质量最低临床重要差异的实现有关.

结论:

将HbA1c降低到8%以下可能会为脊椎手术后的并发症减少带来下降的回报.
脊椎手术患者的最佳HbA1c标需要进一步调查.

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