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血糖变化与非心脏大手术后持续急性损伤之间的关联:多中心回顾性队列研究

Siyu Kong¹, Ke Ding², Huili Jiang³

¹From the School of International Business, China Pharmaceutical University, Jiangsu, China.

Anesthesia and analgesia

|September 13, 2024

概括

非心脏手术后的血糖变化 (GV) 与持续的急性损伤 (AKI) 有关. 特定的GV指标,如MAGE和BGRI,可以识别有风险的患者,这表明改善血糖控制可以预防损伤.

科学领域:

腎臟病學 (nephrology) 是一種醫學.
内分泌学在内分泌学.
外科手术的结果

背景情况:

血糖变化 (GV) 与急性损伤 (AKI) 之间的关联值得关注,但其与非心脏手术后持续的AKI的联系尚不清楚.
了解这种关系对于改善主要非心脏手术后的患者结果至关重要.

研究的目的:

在非心脏手术后48小时内分析GV模式.
为了确定GV指数和持续的AKI在手术后7天内之间的关联.
为了比较不同GV指标的持续AKI的预测能力.

主要方法:

一项对10937名接受非心脏手术的患者进行的回顾性队列研究.
使用变化系数 (CV),血糖游览的平均幅度 (MAGE) 和血糖风险指数 (BGRI) 评估GV.
多变量后勤回归和外部验证用于分析GV-AKI关联和预测性能.

主要成果:

持续性AKI发生在2.5%的患者 (274/10,937) 中.
较高的GV (CV,MAGE,BGRI) 与持续性AKI的风险增加有显著关联.
MAGE和BGRI证明了持续性AKI的独立预测价值,确定了最佳切断点.

结论:

在48小时内术后血糖变化是非心脏手术后持续性AKI的独立风险因素.
确立的GV切断点可以对患有持续性AKI风险的患者进行分层.
经手术期间的血糖控制,通过稳定GV,可以减少脏不良结果的发生率.

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