心脏手术后血糖变异性的预后意义。

Prognostic significance of glycemic variability after cardiac surgery.

作者信息

Bansal Beena, Carvalho Pravin, Mehta Yatin, Yadav Jitender, Sharma Prateek, Mithal Ambrish, Trehan Naresh

机构信息

Division of Endocrinology and Diabetes, Medanta, The Medicity.

Gida, Bengaluru.

出版信息

J Diabetes Complications. 2016 May-Jun;30(4):613-7. doi: 10.1016/j.jdiacomp.2016.02.010. Epub 2016 Feb 11.

DOI:10.1016/j.jdiacomp.2016.02.010

PMID:26965795

Abstract

INTRODUCTION

The prognostic significance of acute glycemic variability (GV) after cardiac surgery is not known. This study was therefore planned to analyze the independent prognostic value of GV after cardiac surgery.

MATERIALS AND METHODS

This is a single center prospective observational study in 870 consecutive cardiac surgery patients over a 3-month period at a tertiary care institute in India.

RESULTS

In linear regression analysis, GV was a significant predictor of length of stay in intensive care unit (LOS-ICU) (beta 0.102, p=0.007) and rise in creatinine after surgery (beta 0.229, p<0.001). Mean POC-BG was a significant positive predictor of length of stay in hospital (LOS-hospital) (beta 0.1, p=0.004). In multivariable logistic regression analysis, GV predicted prolonged LOS-ICU (p=0.006, OR 1.016) and acute kidney injury (p<0.001, OR 1.034).

CONCLUSION

This study showed that GV, as measured by standard deviation, was a predictor of LOS-ICU, rise in creatinine and AKI after cardiac surgery. GV is therefore a new dimension in postoperative glycemic management in cardiac surgery patients, which needs to be explored.

摘要

引言

心脏手术后急性血糖变异性（GV）的预后意义尚不清楚。因此，本研究旨在分析心脏手术后GV的独立预后价值。

材料与方法

这是一项在印度一家三级医疗机构对870例连续心脏手术患者进行的为期3个月的单中心前瞻性观察研究。

结果

在线性回归分析中，GV是重症监护病房住院时间（LOS-ICU）（β=0.102，p=0.007）和术后肌酐升高（β=0.229，p<0.001）的显著预测因素。即时检测血糖（POC-BG）均值是住院时间（LOS-医院）的显著正性预测因素（β=0.1，p=0.004）。在多变量逻辑回归分析中，GV预测了LOS-ICU延长（p=0.006，OR=1.016）和急性肾损伤（p<0.001，OR=1.034）。