持续的术后高血糖与选择性切除术后的死亡率的关联
Jialing He1, Yu Zhang2, Lu Jia3
11Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan.
Journal of neurosurgery
|April 2, 2024
概括
在骨切除术后持续的中度和重度高血糖症显著增加了30天死亡风险. 这种关联甚至适用于患有糖尿病或手术前高血糖症的患者,这突显了手术后血糖控制的重要性.
科学领域:
- 神经外科 神经外科
- 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:
- 在骨切除术后持续的术后高血糖是研究不足的领域.
- 手术后血糖水平升高可能会影响患者的治疗结果.
研究的目的:
- 为了研究持续的手术后高血糖和在接受选择性骨切割的患者的死亡率之间的关联.
- 为了确定高血糖症的严重程度是否影响死亡风险.
主要方法:
- 一项对14907名成年患者进行的队列研究,这些患者在2011年至2021年期间接受了选择性切除术.
- 持续性高血糖症定义为连续≥2次血清葡萄糖水平在切术后7天内升高.
- 血糖水平分为正常血糖,轻度,中度和严重的高血糖.
主要成果:
- 中度和严重的持续性高血糖症与显著更高的30天死亡率有关 (aOR分别为3.76和3.82).
- 轻度高血糖症与死亡率没有显著关联.
- 与手术前水平相比,手术后血糖水平是死亡率的优越预测指标 (AUC 0.78 与 0.65).
- 高血糖也增加了DVT,肺炎,心肌梗塞和长时间住院的风险.
结论:
- 切术后的中度和严重的持续性高血糖是增加30天死亡率的独立风险因素.
- 超血糖和死亡率之间的关联不论是手术前的葡萄糖状况或先前存在的糖尿病.
- 有效的术后葡萄糖管理对于改善切割患者的治疗结果至关重要.
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