Li Xiaojue, Hou Xiaopei, Zhang Heng, Qian Xin, Feng Xinxing, Shi Na, Sun Hansong, Feng Wei, Zhao Wei, Li Guangwei, Zheng Zhe, Chen Yanyan
Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Diabetes Res Clin Pract. 2022 Apr;186:109830. doi: 10.1016/j.diabres.2022.109830. Epub 2022 Mar 16.
To investigate the effect of early postoperative hypoglycaemia on hospitalization outcomes including major cardiovascular complications and in-hospital mortality among patients undergoing coronary artery bypass grafting (CABG).
Data from an observational study of 9583 patients in the intensive care unit (ICU) who underwent CABG were analyzed. Hypoglycaemia was defined as a nadir blood glucose level <70 mg/dL (3.9 mmol/L). One-to-one propensity score matching (PSM) was used to identify 251-balanced pairs of patients to compare outcomes.
A total of 306 (3.2%) patients experienced hypoglycaemia, of whom, 133 had diabetes, 173 hadn't diabetes. Patients who were hypoglycaemia had higher incidences of compositeoutcomes than those without hypoglycaemia (12.1% versus 6.0%, P < 0.0001). Postoperative length of ICU stay was longer in patients with hypoglycaemia [2.8 (0.8-21.0) versus 2.0 (0.25-36.0) days, P < 0.0001]. After PSM, the compositeoutcomes and length of ICU stay remained significantly increased for the patients with hypoglycaemia [compositeoutcomes: odd ratio (OR) 2.78, 95% CI, 1.30-5.88, P = 0.01; length of ICU stay: OR 1.60, 95% CI, 1.14-2.26, P = 0.007].
Postoperative hypoglycaemia was an independent associated factor of adverse composite outcomes and a lengthened ICU stay after CABG. Hypoglycaemia should be avoided for both postoperative patients with and without diabetes.
探讨冠状动脉旁路移植术（CABG）患者术后早期低血糖对包括主要心血管并发症和院内死亡率在内的住院结局的影响。
分析了对9583例在重症监护病房（ICU）接受CABG的患者进行的一项观察性研究的数据。低血糖定义为最低血糖水平<70mg/dL（3.9mmol/L）。采用一对一倾向评分匹配（PSM）来确定251对平衡的患者对以比较结局。
共有306例（3.2%）患者发生低血糖，其中133例患有糖尿病，173例未患糖尿病。发生低血糖的患者的复合结局发生率高于未发生低血糖的患者（12.1%对6.0%，P<0.0001）。低血糖患者的术后ICU住院时间更长[2.8（0.8 - 21.0）天对2.0（0.25 - 36.0）天，P<0.0001]。PSM后，低血糖患者的复合结局和ICU住院时间仍显著增加[复合结局：比值比（OR）2.78，95%置信区间（CI），1.30 - 5.88，P = 0.01；ICU住院时间：OR 1.60，95% CI，1.14 - 2.26，P = 0.007]。
术后低血糖是CABG后不良复合结局和ICU住院时间延长的独立相关因素。无论术后患者有无糖尿病，均应避免低血糖。
