术前低血红蛋白 A1c 水平是食管切除术后围手术期感染并发症的预测因素:一项回顾性单中心研究。

IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global health & medicine Pub Date : 2024-06-30 DOI:10.35772/ghm.2023.01113
Daiki Kato, Kazuhiko Yamada, Naoki Enomoto, Syusuke Yagi, Hanako Koda, Kyoko Nohara
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引用次数: 0

摘要

这项回顾性单中心研究旨在评估一组 176 名患者的血糖 (BG) 指标对食管切除术后围手术期并发症的影响。研究分析包括每日最高血糖水平和血红蛋白 A1c (HbA1c) 与临床病理因素的相关性。术后第 0 天(POD)的最高血糖水平明显高于第 2、3、5 和 7 天(P < 0.05)。此外,术前 HbA1c 水平≥ 5.6% 的患者术后第 1、2 和 7 天的最大血糖水平明显高于术前 HbA1c 水平< 5.6% 的患者(P 均<0.05)。术前 HbA1c 水平< 5.6% 的患者发生任何并发症和感染性并发症的比例均高于术前 HbA1c 水平≥ 5.6% 的患者(两者的 P 均<0.05)。通过逻辑回归分析,术前 HbA1c 水平< 5.6% 是食管切除术后感染性并发症的重要预测因素(P < 0.05)。术前 HbA1c 水平高的患者食管切除术后的最大血糖水平仍然很高,而 HbA1c 水平正常则是感染性并发症的独立风险因素。
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Low preoperative hemoglobin A1c level is a predictor of perioperative infectious complications after esophagectomy: A retrospective, single-center study.

This retrospective, single-center study aimed to evaluate the impact of blood glucose (BG) markers on perioperative complications after esophagectomy in a cohort of 176 patients. Study analyses included the correlation of daily maximum BG level and hemoglobin A1c (HbA1c) with clinicopathological factors. Maximum BG levels were significantly higher on postoperative day (POD) 0 than on PODs 2, 3, 5, and 7 (p < 0.05). Additionally, maximum BG levels on PODs 1, 2, and 7 were significantly higher in patients with preoperative HbA1c levels of ≥ 5.6% than in those with preoperative HbA1c levels of < 5.6% (p < 0.05 for all). The rates of any complications and infectious complications were higher in patients with preoperative HbA1c levels of < 5.6% than in those with preoperative HbA1c levels of ≥ 5.6% (p < 0.05 for both). A preoperative HbA1c level of < 5.6% was a significant predictor of infectious complications after esophagectomy by logistic regression analysis (p < 0.05). Maximum BG level after esophagectomy remained high in patients with high preoperative HbA1c levels, whereas a normal HbA1c level was an independent risk factor for infectious complications.

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