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术前血红蛋白A1c水平低是食管癌切除术后围手术期感染并发症的一个预测指标:一项回顾性单中心研究。

Low preoperative hemoglobin A1c level is a predictor of perioperative infectious complications after esophagectomy: A retrospective, single-center study.

作者信息

Kato Daiki, Yamada Kazuhiko, Enomoto Naoki, Yagi Syusuke, Koda Hanako, Nohara Kyoko

机构信息

Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

Course of advanced and Specialized Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

出版信息

Glob Health Med. 2024 Jun 30;6(3):190-198. doi: 10.35772/ghm.2023.01113.

Abstract

This retrospective, single-center study aimed to evaluate the impact of blood glucose (BG) markers on perioperative complications after esophagectomy in a cohort of 176 patients. Study analyses included the correlation of daily maximum BG level and hemoglobin A1c (HbA1c) with clinicopathological factors. Maximum BG levels were significantly higher on postoperative day (POD) 0 than on PODs 2, 3, 5, and 7 ( < 0.05). Additionally, maximum BG levels on PODs 1, 2, and 7 were significantly higher in patients with preoperative HbA1c levels of ≥ 5.6% than in those with preoperative HbA1c levels of < 5.6% ( < 0.05 for all). The rates of any complications and infectious complications were higher in patients with preoperative HbA1c levels of < 5.6% than in those with preoperative HbA1c levels of ≥ 5.6% ( < 0.05 for both). A preoperative HbA1c level of < 5.6% was a significant predictor of infectious complications after esophagectomy by logistic regression analysis ( < 0.05). Maximum BG level after esophagectomy remained high in patients with high preoperative HbA1c levels, whereas a normal HbA1c level was an independent risk factor for infectious complications.

摘要

这项回顾性单中心研究旨在评估血糖(BG)指标对176例接受食管切除术患者围手术期并发症的影响。研究分析包括每日最高血糖水平和糖化血红蛋白(HbA1c)与临床病理因素的相关性。术后第0天(POD 0)的最高血糖水平显著高于术后第2、3、5和7天(P<0.05)。此外,术前HbA1c水平≥5.6%的患者在术后第1、2和7天的最高血糖水平显著高于术前HbA1c水平<5.6%的患者(均P<0.05)。术前HbA1c水平<5.6%的患者发生任何并发症和感染性并发症的发生率均高于术前HbA1c水平≥5.6%的患者(均P<0.05)。通过逻辑回归分析,术前HbA1c水平<5.6%是食管切除术后感染性并发症的显著预测因素(P<0.05)。术前HbA1c水平高的患者食管切除术后最高血糖水平仍较高,而HbA1c水平正常是感染性并发症的独立危险因素。

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