术后低血糖与选择性切除术后的死亡率的关联
Jialing He1, Yu Zhang2, Xin Cheng1
1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Neurosurgery
|August 15, 2024
概括
在骨切除术后的术后低血糖会增加90天死亡率和主要发病率. 死亡和并发症的风险随着神经外科患者更频繁的低血糖症发作而增加.
科学领域:
- 神经外科 神经外科
- 密集护理医学 密集护理医学
- 内分泌学 在内分泌学.
背景情况:
- 手术后低血糖是经过密集血糖控制的神经外科患者的一个已知的风险.
- 术后低血糖症在骨切除术后对患者结局的具体影响尚未得到充分研究.
研究的目的:
- 为了研究手术后低血糖和90天死亡率之间的联系,在接受选性切割的患者中.
- 评估低血糖严重程度与主要发病率和住院时间之间的关系.
主要方法:
- 一项追溯性队列研究,涉及15,040名接受选性切除术的成年患者.
- 中度低血糖症被定义为血糖<3.9 mmol/L,严重的低血糖<2.2 mmol/L.
- 分析了90天死亡率,主要发病率和住院时间,使用多变量回归.
主要成果:
- 3.4%的人患有中度低血糖症,0.8%的人患有严重的低血糖症.
- 中度 (aOR1.86) 和严重 (aOR2.94) 低血糖都与90天死亡率的增加有关.
- 低血糖显著增加了主要发病率 (aORs2.78-16.70) 和长时间住院 (aORs3.20-14.03).
- 观察到剂量-反应关系,低血糖症发作增加与较高的死亡率和发病率风险相关.
结论:
- 手术后的中度和重度低血糖明显与增加的死亡率,主要发病率和选择性骨切除术后更长的住院时间有关.
- 在这种患者群体中,随着低血糖发作频率的增加,不良结果的风险会升级.
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