在老年关节骨折患者中,术前持续高血糖和术后狂妄之间存在关联
Wei Wang1, Yingqi Zhang2, Wei Yao1
1Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China.
BMC geriatrics
|July 8, 2024
概括
较高的手术前高血糖水平显著增加了老年骨折患者手术后妄想症 (POD) 的风险. 这种剂量反应关系凸显了手术前控制血糖水平的重要性.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 内分泌学 在内分泌学.
背景情况:
- 在老年关节骨折患者中,手术前血糖控制和术后妄想 (POD) 之间的联系受到争议.
- 在手术前持续的高血糖可能会增加POD风险.
研究的目的:
- 研究老年骨折患者手术前高血糖和POD发病率之间的关联.
- 确定手术前葡萄糖水平和POD风险之间是否存在剂量反应关系.
主要方法:
- 对1440名关节骨折患者的回顾性队列研究 (2013年1月至2023年11月).
- 根据手术前高血糖 (≥6.1mmol/L) 和血糖值进行分类的患者.
- 多变量逻辑回归和倾向得分匹配 (PSM) 分析了葡萄糖-POD关联.
主要成果:
- POD的发生率为19.1% (275/1440).
- 高血糖症增加了POD风险的1.65倍 (95% CI:1.17-2.32).
- 一个线性趋势显示,高葡萄糖水平增加了POD风险,PSM证实了这一点. 每增加1mmol/L的葡萄糖与6%的POD风险增加相关 (95%CI:1-12%).
结论:
- 在手术前血糖水平和POD风险之间存在明显的线性剂量反应关系.
- 术前高血糖明显与这一群体中术后狂妄症的发病率更高有关.
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