Department of Medicine, Emory University, Atlanta, GA, United States.
Rollins School of Public Health, Emory University, Atlanta, GA, United States.
J Diabetes Complications. 2018 Mar;32(3):305-309. doi: 10.1016/j.jdiacomp.2017.11.010. Epub 2017 Nov 29.
To determine the frequency of increasing levels of stress hyperglycemia and its associated complications in surgery patients without a history of diabetes.
We reviewed hospital outcomes in 1971 general surgery patients with documented preoperative normoglycemia [blood glucose (BG) <140mg/dL] who developed stress hyperglycemia (BG >140mg/dL or >180mg/dL) within 48h after surgery between 1/1/2010 and 10/31/2015.
A total of 415 patients (21%) had ≥1 episode of BG between 140 and 180mg/dL and 206 patients (10.5%) had BG>180mg/dL. The median length of hospital stay (LOS) was 9days [interquartile range (IQR) 5,15] for BG between 140 and 180mg/dL and 12days (IQR 6,18) for BG>180mg/dL compared to normoglycemia at 6days (IQR 4,11), both p<0.001. Patients with BG 140-180mg/dL had higher rates of complications with an odds ratio (OR) of 1.68 [95% confidence interval (95% CI) 1.15-2.44], and those with BG>180mg/dL had more complications [OR 3.46 (95% CI 2.24-5.36)] and higher mortality [OR 6.56 (95% CI 2.12-20.27)] compared to normoglycemia.
Increasing levels of stress hyperglycemia are associated with higher rates of perioperative complications and hospital mortality in surgical patients without diabetes.
确定无糖尿病病史的手术患者中应激性高血糖水平升高及其相关并发症的发生率。
我们回顾了 2010 年 1 月 1 日至 2015 年 10 月 31 日期间，1971 例术前血糖正常（血糖 <140mg/dL）的普外科患者中，术后 48 小时内发生应激性高血糖（血糖>140mg/dL 或 >180mg/dL）的患者的住院结局。
共有 415 例（21%）患者至少出现 1 次血糖在 140-180mg/dL 之间，206 例（10.5%）患者血糖>180mg/dL。血糖在 140-180mg/dL 之间的患者中位住院时间（LOS）为 9 天[四分位间距（IQR）5，15]，血糖>180mg/dL 的患者 LOS 为 12 天（IQR 6，18），而血糖正常的患者 LOS 为 6 天（IQR 4，11），两者均<0.001。血糖在 140-180mg/dL 之间的患者并发症发生率较高，优势比（OR）为 1.68[95%置信区间（95%CI）1.15-2.44]，血糖>180mg/dL 的患者并发症更多[OR 3.46（95%CI 2.24-5.36）]，死亡率更高[OR 6.56（95%CI 2.12-20.27）]。
在无糖尿病病史的手术患者中，应激性高血糖水平升高与围手术期并发症和住院死亡率升高相关。
