Griffee Matthew J, Leis Aleda M, Pace Nathan L, Shah Nirav, Kumar Sathish S, Mentz Graciela B, Riegger Lori Q
Department of Anesthesiology, School of Medicine, University of Utah, Salt Lake City, UT, USA.
Department of Anesthesiology, University of Utah School of Medicine, 5050 30 North Mario Capecchi Drive, Salt Lake City, UT, 84112, USA.
Can J Anaesth. 2025 Jan;72(1):119-131. doi: 10.1007/s12630-024-02816-z. Epub 2024 Aug 13.
Intraoperative hypoglycemia is presumed to be rare, but generalizable multicentre incidence and risk factor data for adult patients are lacking. We used a multicentre registry to characterize adults with intraoperative hypoglycemia and hypothesized that intraoperative insulin administration would be associated with hypoglycemia.
We conducted a cross-sectional retrospective multicentre cohort study. We searched the Multicenter Perioperative Outcomes Group registry to identify adult patients with intraoperative hypoglycemia (glucose < 3.3 mmol·L [< 60 mg·dL]) from 1 January 2015 to 31 December 2019. We evaluated characteristics of patients with intraoperative glucose measurements and with intraoperative hypoglycemia.
Of 516,045 patients with intraoperative glucose measurements, 3,900 (0.76%) had intraoperative hypoglycemia. Diabetes mellitus and chronic kidney disease were more common in the cohort with intraoperative hypoglycemia. The odds of intraoperative hypoglycemia were higher for the youngest age category (18-30 yr) compared with the odds for every age category above 40 yr (odds ratio [OR], 1.57-3.18; P < 0.001), and were higher for underweight or normal weight patients compared with patients with obesity (OR, 1.48-2.53; P < 0.001). Parenteral nutrition was associated with lower odds of hypoglycemia (OR, 0.23; 95% confidence interval [CI], 0.11 to 0.47; P < 0.001). Intraoperative insulin use was not associated with hypoglycemia (OR, 0.996; 95% CI, 0.91 to 1.09; P = 0.93).
In this large cross-sectional retrospective multicentre cohort study, intraoperative hypoglycemia was a rare event. Intraoperative insulin use was not associated with hypoglycemia.
术中低血糖被认为较为罕见，但缺乏针对成年患者的可推广的多中心发病率及风险因素数据。我们利用一个多中心登记处来描述术中发生低血糖的成年患者特征，并假设术中胰岛素给药与低血糖有关。
我们开展了一项横断面回顾性多中心队列研究。我们检索了多中心围手术期结局组登记处，以识别2015年1月1日至2019年12月31日期间术中发生低血糖（血糖＜3.3 mmol·L[＜60 mg·dL]）的成年患者。我们评估了有术中血糖测量值以及发生术中低血糖的患者的特征。
在516,045例有术中血糖测量值的患者中，3900例（0.76%）发生了术中低血糖。糖尿病和慢性肾脏病在术中发生低血糖的队列中更为常见。最年轻年龄组（18 - 30岁）术中发生低血糖的几率高于40岁以上各年龄组（比值比[OR]，1.57 - 3.18；P＜0.001），体重过轻或正常体重的患者术中发生低血糖的几率高于肥胖患者（OR，1.48 - 2.53；P＜0.001）。肠外营养与较低的低血糖几率相关（OR，0.23；95%置信区间[CI]，0.11至0.47；P＜0.001）。术中使用胰岛素与低血糖无关（OR，0.996；95% CI，0.91至1.09；P = 0.93）。
在这项大型横断面回顾性多中心队列研究中，术中低血糖是一种罕见事件。术中使用胰岛素与低血糖无关。
