在一般外科手术中进行手术前的血红蛋白A1C,血糖状况和术后的结果
Thomas Schaschinger1, Tobias Niederegger1, Jule Brandt1
1Medical Faculty, University of Heidelberg, Heidelberg, Germany.
JAMA surgery
|November 5, 2025
概括
在一般手术患者的手术前血红蛋白A1C (HbA1c) 查至关重要. 升高的HbA1c,即使未被诊断,也会显著增加术后并发症,再入院和死亡率的风险,强调需要更好的血糖管理.
科学领域:
- 手术结果研究研究.
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 低血糖是不良手术结果的已知危险因素.
- 在整体外科手术中进行手术前血红蛋白A1C (HbA1c) 查的作用还不清楚.
研究的目的:
- 调查HbA1c水平升高与一般手术患者的30天术后并发症,再入院和死亡率之间的关联.
主要方法:
- 使用美国外科医生学院国家外科质量改进计划数据库 (2021-2023) 进行回顾性队列研究.
- 包括接受全科手术的成年患者,可用HbA1c数据.
- 多变量逻辑回归分析了血糖状况和结果之间的关联.
主要成果:
- 在282,131名患者中,36%被诊断为糖尿病,6.4%未被诊断为糖尿病 (HbA1c>6.4%).
- 在被诊断为糖尿病的患者中,增加的HbA1c水平与更高的并发症风险相关.
- 未诊断的糖尿病与增加的医疗并发症和死亡率有关.
结论:
- 糖尿病,诊断或未诊断,是普遍存在的,并且独立地与更糟糕的外科手术结果相关.
- 建议进行常规的手术前HbA1c查和个性化血糖管理,以优化手术风险并改善患者的治疗结果.
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