Lee Okjoo, Lim Chang-Sup, Yoon So Jeong, Jung Ji Hye, Shin Sang Hyun, Heo Jin Seok, Shin Yong Chan, Jung Woohyun, Han In Woong
Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170, Jomaru-ro, Bucheon 14584, Korea.
Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea.
Biomedicines. 2022 Sep 28;10(10):2427. doi: 10.3390/biomedicines10102427.
The adequate regulation of postoperative serum glucose level (SGL) is widely accepted; however, the effects for non-diabetic patients who underwent major pancreatic surgery have not yet been established. We discerned the relevance of the immediately postoperative SGL to short-term postoperative outcomes from major pancreatic surgery in non-diabetic patients. Between January 2007 and December 2016, 2259 non-diabetic patients underwent major pancreatic surgery at four tertiary medical centers in Republic of Korea. Based on a SGL of 200 mg/dL, patients were classified into two groups by averaging the results of four SGL tests taken on the first day after surgery, and their short-term postoperative outcomes were analyzed. A 1:1 propensity score matching method was conducted to establish the high SGL group ( = 568) and the normal SGL group ( = 568). The high SGL group experienced a significantly higher rate of level C complications in the Clavien-Dindo classification (CDc) than the normal SGL group (24.1% vs. 16.5%, = 0.002). Additionally, an SGL of more than 200 mg/dL was associated with a significantly high risk of complications above level C CDc after adjusting for other risk factors (hazard ratio = 1.324, 95% confidence interval = 1.048-1.672, = 0.019). The regulation of SGL of less than 200 mg/dL in non-diabetic patients early after major pancreatic surgery could be helpful for reducing postoperative complications.
术后血糖水平(SGL)的适当调控已被广泛接受;然而,对于接受大型胰腺手术的非糖尿病患者,其效果尚未明确。我们探讨了非糖尿病患者大型胰腺手术后即刻SGL与术后短期结局的相关性。2007年1月至2016年12月期间,2259例非糖尿病患者在韩国的四个三级医疗中心接受了大型胰腺手术。根据术后第一天四次SGL检测结果的平均值,以200mg/dL的SGL为界,将患者分为两组,并分析其术后短期结局。采用1:1倾向评分匹配法建立高SGL组(n = 568)和正常SGL组(n = 568)。高SGL组Clavien-Dindo分类(CDc)中C级并发症发生率显著高于正常SGL组(24.1%对16.5%,P = 0.002)。此外,在调整其他危险因素后,SGL超过200mg/dL与C级以上CDc并发症的高风险显著相关(风险比 = 1.324,95%置信区间 = 1.048 - 1.672,P = 0.019)。在非糖尿病患者大型胰腺手术后早期将SGL调控至低于200mg/dL可能有助于降低术后并发症。