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非原性低血糖症:一个普遍的标志物,对糟糕的结果
Hannah Rando1, Matthew Acton1, Ifeanyi Chinedozi1
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
心脏手术后的术后低血糖症与不良结果有关. 阳性低血糖症,通常是因胰岛素错误引起的,死亡率明显低于非阳性原因.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临界护理医学 临界护理医学
背景情况:
- 以前的研究将术后低血糖与心脏手术中的不良结果联系在一起.
- 这些研究中以前没有考虑过低血糖的原因.
研究的目的:
- 调查术后低血糖的原因和心脏手术后的不良结果之间的关联.
- 为了区分iatrogenic和noniatrogenic低血糖之间的结果.
主要方法:
- 对5373名心脏手术患者 (2016-2021) 的回顾性审查.
- 低血糖症定义为术后血糖<70 mg/dL.
- 分类为亚原性 (例如,胰岛素错误) 和非亚原性 (例如,肝衰竭,败血症) 的原因.
主要成果:
- 5%的患者患有低血糖症,63%的患者患有阳性,37%的患者患有非阳性.
- 两种类型的低血糖都与增加的功能衰竭,延长的通风和ICU停留有关.
- 非原性低血糖症显著增加死亡率 (OR 68.6),而原性低血糖症没有 (OR 1.45).
结论:
- 在评估心脏手术后的结果时,低血糖的原因至关重要.
- 与非原性原因相比,原性低血糖症,特别是因胰岛素管理错误而产生的低血糖症,与发病率和死亡率的关联大大减弱.
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