Department of Orthopedics, Dandong Central Hospital, China Medical University, No. 338 Jinshan Street, Zhenxing District, Dandong, Liaoning Province, 118002, P.R. China.
Department of Oncology, Dandong Central Hospital, China Medical University, No. 338 Jinshan Street, Zhenxing District, Dandong, Liaoning Province, 118002, P.R. China.
BMC Musculoskelet Disord. 2023 Sep 1;24(1):700. doi: 10.1186/s12891-023-06829-5.
Admission hyperglycemia is a common phenomenon in the early stages of injury. This study aimed to determine the relationship between admission hyperglycemia and postoperative pneumonia in geriatric patients with hip fractures.
A total of 600 geriatric patients admitted to Dandong Central Hospital with hip fractures were included. Patients were divided into four groups based on quartiles of admission blood glucose levels: Q1- Q4. Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for postoperative pneumonia. Receiver operating characteristic (ROC) curves were used to determine the cut-off value of admission hyperglycemia for predicting postoperative pneumonia.
The incidence of postoperative pneumonia was significantly higher among hyperglycemic patients than those with normal glucose levels (OR = 2.090, 95% CI: 1.135-3.846, p = 0.016). Admission hyperglycemia showed moderate predictive power, with an area under the ROC curve of 0.803. Furthermore, propensity score-matched analyses demonstrated that patients in the Q3 (OR = 4.250, 95% CI: 1.361-13.272, p = 0.013) and Q4 (OR = 4.667, 95% CI: 1.251-17.405, p = 0.022) quartiles had a significantly higher risk of postoperative pneumonia compared to patients in the Q1 quartile.
Admission hyperglycemia in elderly hip fracture patients increases the risk of postoperative pneumonia. This biomarker can aid clinical assessment and perioperative management.
入院时的高血糖是损伤早期的常见现象。本研究旨在确定老年髋部骨折患者入院时高血糖与术后肺炎之间的关系。
共纳入 600 例因髋部骨折入住丹东市中心医院的老年患者。根据入院血糖水平的四分位数将患者分为 4 组：Q1-Q4。采用多变量逻辑回归和倾向评分匹配分析计算术后肺炎的校正优势比（OR）和 95%置信区间（CI）。采用受试者工作特征（ROC）曲线确定入院高血糖预测术后肺炎的截断值。
高血糖患者术后肺炎发生率明显高于血糖正常患者（OR=2.090，95%CI：1.135-3.846，p=0.016）。入院高血糖具有中等预测能力，ROC 曲线下面积为 0.803。此外，倾向评分匹配分析表明，Q3 组（OR=4.250，95%CI：1.361-13.272，p=0.013）和 Q4 组（OR=4.667，95%CI：1.251-17.405，p=0.022）患者术后肺炎的风险明显高于 Q1 组患者。
老年髋部骨折患者入院时的高血糖增加了术后肺炎的风险。该生物标志物有助于临床评估和围手术期管理。
