术前葡萄糖失调与非心脏手术后狂妄症之间的关联
Ah Ran Oh1,2, Dong Yun Lee3, Seunghwa Lee4,5
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Journal of clinical medicine
|February 24, 2024
概括
手术前的葡萄糖失调,包括高血糖和低血糖,增加了非心脏手术后手术后 Delirium 的风险. 该协会强调了神妄预防策略的潜在目标.
科学领域:
- 麻醉学和外科手术期间的医学.
- 代谢障碍 代谢障碍 代谢障碍
- 老年医学 老年医学
背景情况:
- 痴呆症是非心脏手术后的常见和严重并发症.
- 葡萄糖失调是一种常见的疾病,可能会影响术后的结果.
- 术前葡萄糖水平与妄想风险之间的特定关联需要进一步阐明.
研究的目的:
- 调查手术前葡萄糖失调 (高血糖症,低血糖症或两者) 与手术后狂妄症发生率之间的关联.
- 为了比较非心脏手术后血糖失调和没有血糖失调的患者的妄想率.
- 探索糖尿病状况对葡萄糖失调和妄想之间的关系的影响.
主要方法:
- 对61,805名接受非心脏手术且手术前可用的葡萄糖水平的患者进行了回顾性队列研究.
- 根据手术前24小时内血糖水平,将患者分为高血糖,低血糖或两组.
- 使用调整的危险比率,比较暴露和未暴露组之间的30天术后妄想发病率.
主要成果:
- 与正常血糖患者相比,患有高血糖症,低血糖症或两者的患者表现出更高的术后狂妄症率.
- 经过调整后的分析显示,妄想风险增加:高血糖1.35的HR,低血糖1.36的HR,两者的HR为3.14.
- 不管糖尿病状况如何,高血糖症始终与妄想风险有关,而糖尿病患者的低血糖症相关性并不显著.
结论:
- 术前葡萄糖失调是非心脏手术后发生术后 Delirium 的重要危险因素.
- 过高血糖症与妄想有着一致的关联,即使在没有糖尿病的患者中也是如此.
- 这些发现强调了监测和管理手术前葡萄糖水平的重要性,以减轻妄想风险.
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