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非糖尿病患者心脏手术后压力高血糖症的危险因素和预测模型
Mengli Zhang1, Jinyan Wu1, Lulu Wang2
1School of Nursing, Bengbu Medical University, Bengbu, Anhui, People's Republic of China.
Journal of multidisciplinary healthcare
|April 28, 2025
概括
一个新的模型有效地预测了心脏手术后非糖尿病患者的压力高血糖 (SHG) 风险. 关键的危险因素包括心肺绕道期间的高脂血症,高血压和高氧症,使得早期干预成为可能.
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:
- 压力高血糖 (SHG) 是心脏手术后没有糖尿病的患者常见的并发症.
- 预测SHG风险对于及时干预和改善患者结果至关重要.
研究的目的:
- 开发和验证在接受心脏手术的非糖尿病患者中对SHG风险的预测模型.
- 确定与心脏手术后SHG发展相关的重大风险因素.
主要方法:
- 495名接受心脏手术的非糖尿病患者的回顾性分析 (2020年6月 - 2023年12月).
- 发育样本 (n=333) 和外部验证样本 (n=162).
- 多变量分析以确定重大风险因素并构建预测模型.
主要成果:
- 71.9%的患者发生了SHG.
- 确定了重要的危险因素:高脂血症,冠状动脉绕道移植 (CABG),高血压,输血,BMI≥28 kg/m2,心肺绕道期间高氧化 (PaO2≥300mmHg).
- 该模型表现出良好的预测性能,AUC在开发组为0.85,在验证组为0.805.
结论:
- 超脂血症,CABG,高血压,输血,高BMI和CPB期间的高氧是该人群中SHG的显著预测因素.
- 开发的风险预测模型有效地识别了高风险的SHG患者.
- 早期识别有助于采取有针对性的干预措施,以减少SHG发生率和相关并发症.
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