心脏手术后无糖尿病患者术后应激性高血糖相关危险因素的系统评价和荟萃分析

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Reviews in cardiovascular medicine Pub Date : 2025-01-21 eCollection Date: 2025-01-01 DOI:10.31083/RCM25485

Mengli Zhang, Ziyi Zhang, Ningning Zhu, Lulu Wang, Hui Huang, Yike Wang, Fang Xue

{"title":"心脏手术后无糖尿病患者术后应激性高血糖相关危险因素的系统评价和荟萃分析","authors":"Mengli Zhang, Ziyi Zhang, Ningning Zhu, Lulu Wang, Hui Huang, Yike Wang, Fang Xue","doi":"10.31083/RCM25485","DOIUrl":null,"url":null,"abstract":"Background: To systematically evaluate risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery.Methods: Databases including CNKI, WanFang data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library were searched using computer retrieval. The data were subjected to an in-depth meta-analysis using RevMan 5.4 and Stata 15.0 software.Results: This study involved 11,645 postoperative cardiac surgery patients, including 8 case-control studies and 3 cohort studies, over which 18 risk factors were identified. The results of the meta-analysis indicated that statistically significant risk factors included age >65 years [odds ratios (OR) (95% CI ) = 3.47 (2.61-4.32)], female gender [OR (95%) = 1.54 (1.34-1.76)], combined heart valve and coronary artery bypass surgery [OR (95%) = 1.82 (1.23-2.70)], ejection fraction <40% [OR (95%) = 1.38 (1.17-1.63)], history of heart surgery [OR (95%) = 1.30 (1.06-1.59)], myocardial infarction [OR (95%) = 1.17 (1.05-1.31)], hyperlipidemia [OR (95%) = 0.76 (0.67-0.86)], hypertension [OR (95%) = 1.12 (1.03-1.22)], anticoagulant medication [OR (95%) = 0.77 (0.65-0.90)], cardiopulmonary bypass time >2 hours [OR (95%) = 20.26 (17.03-23.48)] and history of cardiopulmonary bypass [OR (95%) = 1.24 (1.09-1.41)].Conclusions: Current evidence suggests that there are key risk factors for postoperative stress hyperglycemia in patients without diabetes who have undergone cardiac surgery. These factors can help identify patients at a high risk of perioperative stress hyperglycemia during cardiac surgery. This evidence provides a basis for healthcare professionals to develop predictive management strategies for perioperative stress hyperglycemia in patients without diabetes. However, more high-quality studies are required to address the limitations of the current research.The prospero registration: CRD42024479215, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215.","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25485"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759972/pdf/","citationCount":"0","resultStr":"{\"title\":\"Systematic Review and Meta-Analysis of Risk Factors Associated with Postoperative Stress Hyperglycemia in Patients without Diabetes Following Cardiac Surgery.\",\"authors\":\"Mengli Zhang, Ziyi Zhang, Ningning Zhu, Lulu Wang, Hui Huang, Yike Wang, Fang Xue\",\"doi\":\"10.31083/RCM25485\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: To systematically evaluate risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery.Methods: Databases including CNKI, WanFang data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library were searched using computer retrieval. The data were subjected to an in-depth meta-analysis using RevMan 5.4 and Stata 15.0 software.Results: This study involved 11,645 postoperative cardiac surgery patients, including 8 case-control studies and 3 cohort studies, over which 18 risk factors were identified. The results of the meta-analysis indicated that statistically significant risk factors included age >65 years [odds ratios (OR) (95% CI ) = 3.47 (2.61-4.32)], female gender [OR (95%) = 1.54 (1.34-1.76)], combined heart valve and coronary artery bypass surgery [OR (95%) = 1.82 (1.23-2.70)], ejection fraction <40% [OR (95%) = 1.38 (1.17-1.63)], history of heart surgery [OR (95%) = 1.30 (1.06-1.59)], myocardial infarction [OR (95%) = 1.17 (1.05-1.31)], hyperlipidemia [OR (95%) = 0.76 (0.67-0.86)], hypertension [OR (95%) = 1.12 (1.03-1.22)], anticoagulant medication [OR (95%) = 0.77 (0.65-0.90)], cardiopulmonary bypass time >2 hours [OR (95%) = 20.26 (17.03-23.48)] and history of cardiopulmonary bypass [OR (95%) = 1.24 (1.09-1.41)].Conclusions: Current evidence suggests that there are key risk factors for postoperative stress hyperglycemia in patients without diabetes who have undergone cardiac surgery. These factors can help identify patients at a high risk of perioperative stress hyperglycemia during cardiac surgery. This evidence provides a basis for healthcare professionals to develop predictive management strategies for perioperative stress hyperglycemia in patients without diabetes. However, more high-quality studies are required to address the limitations of the current research.The prospero registration: CRD42024479215, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215.\",\"PeriodicalId\":20989,\"journal\":{\"name\":\"Reviews in cardiovascular medicine\",\"volume\":\"26 1\",\"pages\":\"25485\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-01-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759972/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews in cardiovascular medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.31083/RCM25485\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM25485","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：系统评价非糖尿病患者心脏手术后应激性高血糖的危险因素。方法：计算机检索中国知网、万方数据、维普、中国医学信息网、PubMed、Web of Science、Embase、Cochrane Library等数据库。使用RevMan 5.4和Stata 15.0软件对数据进行深入的meta分析。结果：本研究共纳入11645例心脏手术术后患者，包括8项病例对照研究和3项队列研究，共确定18项危险因素。meta分析结果显示，具有统计学意义的危险因素包括年龄[比值比（OR） (95% CI) = 3.47(2.61 ~ 4.32)]、女性[OR(95%) = 1.54(1.34 ~ 1.76)]、心脏瓣膜联合冠状动脉搭桥手术[OR(95%) = 1.82(1.23 ~ 2.70)]、射血分数2小时[OR(95%) = 20.26(17.03 ~ 23.48)]、体外循环史[OR(95%) = 1.24(1.09 ~ 1.41)]。结论：目前的证据表明，非糖尿病心脏手术患者术后应激性高血糖的关键危险因素。这些因素可以帮助识别心脏手术围手术期应激性高血糖的高危患者。这一证据为医疗保健专业人员制定非糖尿病患者围手术期应激性高血糖的预测管理策略提供了基础。然而，需要更多高质量的研究来解决当前研究的局限性。普洛斯彼罗注册：CRD42024479215， https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

摘要图片

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Systematic Review and Meta-Analysis of Risk Factors Associated with Postoperative Stress Hyperglycemia in Patients without Diabetes Following Cardiac Surgery.

Background: To systematically evaluate risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery.

Methods: Databases including CNKI, WanFang data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library were searched using computer retrieval. The data were subjected to an in-depth meta-analysis using RevMan 5.4 and Stata 15.0 software.

Results: This study involved 11,645 postoperative cardiac surgery patients, including 8 case-control studies and 3 cohort studies, over which 18 risk factors were identified. The results of the meta-analysis indicated that statistically significant risk factors included age >65 years [odds ratios (OR) (95% CI ) = 3.47 (2.61-4.32)], female gender [OR (95%) = 1.54 (1.34-1.76)], combined heart valve and coronary artery bypass surgery [OR (95%) = 1.82 (1.23-2.70)], ejection fraction <40% [OR (95%) = 1.38 (1.17-1.63)], history of heart surgery [OR (95%) = 1.30 (1.06-1.59)], myocardial infarction [OR (95%) = 1.17 (1.05-1.31)], hyperlipidemia [OR (95%) = 0.76 (0.67-0.86)], hypertension [OR (95%) = 1.12 (1.03-1.22)], anticoagulant medication [OR (95%) = 0.77 (0.65-0.90)], cardiopulmonary bypass time >2 hours [OR (95%) = 20.26 (17.03-23.48)] and history of cardiopulmonary bypass [OR (95%) = 1.24 (1.09-1.41)].

Conclusions: Current evidence suggests that there are key risk factors for postoperative stress hyperglycemia in patients without diabetes who have undergone cardiac surgery. These factors can help identify patients at a high risk of perioperative stress hyperglycemia during cardiac surgery. This evidence provides a basis for healthcare professionals to develop predictive management strategies for perioperative stress hyperglycemia in patients without diabetes. However, more high-quality studies are required to address the limitations of the current research.

The prospero registration: CRD42024479215, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.