Chrastil Jesse, Anderson Mike B, Stevens Vanessa, Anand Rahul, Peters Christopher L, Pelt Christopher E
University of Utah, Department of Orthopaedics, Salt Lake City, Utah.
University of Utah, Pharmacotherapy Outcomes Research Center, College of Pharmacotherapy, Salt Lake City, Utah; IDEAS 2.0, Veterans Affairs Salt Lake City Health System, Salt Lake City, Utah.
J Arthroplasty. 2015 Jul;30(7):1197-202. doi: 10.1016/j.arth.2015.01.040. Epub 2015 Jan 31.
We sought to determine if HbA1c and perioperative hyperglycemia were positively associated with the incidence of PJI. We retrospectively reviewed the VA VINCI database on patients who underwent primary joint arthroplasty between 2001 and 2011 and had HbA1c and perioperative blood glucose levels. Of 13,272 patients, 38% (n=5035) had an elevated perioperative HbA1c ≥7%. While there was no increased risk of infection associated with elevated HbA1c (HR 0.86, P=0.23), mortality was increased (HR 1.3, P=0.01). Preoperative hyperglycemia was associated with an increased incidence of PJI (HR 1.44, P=0.008). While HbA1c did not perfectly correlate with the risk of PJI, perioperative hyperglycemia did, and may be a target for optimization to decrease the burden of PJI.
我们试图确定糖化血红蛋白（HbA1c）和围手术期高血糖是否与人工关节感染（PJI）的发生率呈正相关。我们回顾性分析了2001年至2011年间接受初次关节置换术且有HbA1c和围手术期血糖水平的退伍军人事务部（VA）VINCI数据库。在13272例患者中，38%（n = 5035）的患者围手术期HbA1c升高≥7%。虽然HbA1c升高与感染风险增加无关（风险比[HR] 0.86，P = 0.23），但死亡率增加（HR 1.3，P = 0.01）。术前高血糖与PJI发生率增加相关（HR 1.44，P = 0.008）。虽然HbA1c与PJI风险并非完全相关，但围手术期高血糖与之相关，并且可能是优化以减轻PJI负担的一个靶点。
