通过在结直肠手术后实施临床药师主导的血糖管理模式，改善术后血糖控制。

Improved postoperative blood glucose control through implementation of clinical pharmacist driven glycemic management model after colorectal surgery.

机构信息

Mayo Clinic, 201 West Center Street, Rochester, MN, 55902, USA.

出版信息

Am J Surg. 2023 Jun;225(6):1050-1055. doi: 10.1016/j.amjsurg.2022.12.018. Epub 2022 Dec 27.

DOI:10.1016/j.amjsurg.2022.12.018

PMID:36609079

Abstract

BACKGROUND

Poor postoperative glycemic control has been linked with higher mortality, cardiovascular complications, stroke, infection, impaired wound healing, and increased length of stay.

METHODS

This multicenter, retrospective study of colorectal surgery patients with Type 2 Diabetes Mellitus evaluated the difference in mean blood glucose levels postoperatively in a pharmacist driven glycemic management model vs standard of care. Secondary objectives assessed hyperglycemic events, severe hyperglycemia, hypoglycemia, postoperative infection, and rates of endocrinology consults.

RESULTS

186 patients were included, 120 in the pharmacist driven cohort and 66 in the standard of care. The pharmacist managed cohort demonstrated significantly lower mean blood glucose (133.9 vs 148.3 mg/dL, 95% CI [-17 to -11] p < 0.001), significantly fewer hyperglycemic events (9.6% vs 20.5%, p < 0.0001), and non-significant reduction of hypoglycemic events (0.7% vs 1.2%, p = 0.1443).

CONCLUSIONS

Expansion of the postoperative care team by utilizing pharmacists to manage postoperative blood glucose resulted in improved glycemic control.

摘要

背景

术后血糖控制不佳与更高的死亡率、心血管并发症、中风、感染、伤口愈合不良和住院时间延长有关。

方法

这项多中心、回顾性研究纳入了患有 2 型糖尿病的结肠直肠手术患者，评估了在药师主导的血糖管理模式与常规护理下术后平均血糖水平的差异。次要目标评估了高血糖事件、严重高血糖、低血糖、术后感染以及内分泌会诊的发生率。

结果

共纳入 186 例患者，其中 120 例在药师管理组，66 例在常规护理组。药师管理组的平均血糖明显更低（133.9 与 148.3mg/dL，95%置信区间[-17 至-11]，p<0.001），高血糖事件明显更少（9.6%与 20.5%，p<0.0001），低血糖事件虽非显著减少（0.7%与 1.2%，p=0.1443）。