手术前的葡萄糖水平是否预测了骨科手术中并发症的风险?
Natalie Kieruzel1, Sahil Sethi2, Vivek Nair2
1Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL, 60064, USA.
概括
手术前高血糖会增加骨科手术后伤口并发症的风险. 手术当天的血糖查可以识别患有不良伤口愈合风险较高的患者.
科学领域:
- 整形外科手术 整形外科手术
- 代谢障碍 代谢障碍 代谢障碍
- 手术并发症 手术并发症
背景情况:
- 手术后高血糖是手术并发症的一个已知的危险因素.
- 手术前血糖水平对手术结果的预测作用仍然不太清楚.
- 了解这些关联对于优化患者护理和减少不良事件至关重要.
研究的目的:
- 为了确定手术前血糖水平是否会影响手术后感染或伤口并发症的发生率.
- 调查病例的紧急性或解剖位置是否会改变手术前葡萄糖和并发症之间的关系.
- 评估术前血糖查作为风险分层工具的有用性.
主要方法:
- 775名成年骨科手术患者 (2018-2021) 的回顾性图表审查.
- 收集的数据包括手术前的血糖 (12小时内) 和HbA1c (3个月内).
- 评估的结果是手术后感染和伤口并发症,按病例紧急性和解剖部位分层.
主要成果:
- 平均手术前葡萄糖为127.7 mg/dL;平均HbA1c为6.9%.
- 血糖水平升高与感染并发症的几率更高有关 (每增加1个点的OR为1.01).
- 手术前葡萄糖>137 mg/dL与增加的伤口并发症相关,但不是深层感染.
结论:
- 在骨科手术中,手术前高血糖与增加的伤口并发症有关,而不是深层感染.
- 解剖部位和病例紧急性并没有改变术前葡萄糖对感染率的影响.
- 在手术当天的医疗点血糖查可以作为分层手术风险的宝贵工具.
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