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经皮椎体成形术治疗骨质疏松性椎体压缩骨折患者术前血糖水平与全因死亡率的关系。

Relationship between preoperative glucose level and all-cause mortality in patients with osteoporotic vertebral compression fracture who underwent percutaneous vertebroplasty.

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Sci Rep. 2024 Aug 31;14(1):20265. doi: 10.1038/s41598-024-71467-3.

Abstract

To investigate the relationship between preoperative blood glucose levels and long-term all-cause mortality in patients with osteoporotic vertebral compression fractures (OVCF) who underwent percutaneous vertebroplasty (VP). This single-center retrospective study involved a chart review of patients admitted for VP to treat OVCF between 2013 and 2020. Patients with pathological or multiple fractures or those who did not undergo bone mineral density assessment were excluded. All relevant information was collected from electronic medical records. The survival status of all patients was confirmed at the end of March 2021. Cox proportional hazard models with multivariate adjustments were used to examine the effects of blood glucose levels on all-cause mortality. Overall, 131 patients were retrospectively analyzed (mean age: 75.8 ± 9.3 years, male patients: 26.7%) with a median follow-up period of 2.1 years. Preoperative hyperglycemia (hazard ratio: 2.668, 95% confidence interval [CI] 1.064, 6.689; p = 0.036) and glucose levels (hazard ratio: 1.007, 95% CI 1.002-1.012; p = 0.006) were found to be independently associated with a higher risk of all-cause mortality. This correlation remained significant even after adjusting for age and sex, and other factors and comorbidities that might affect outcomes (hazard ratio: 2.708, 95% CI 1.047, 7.003, p = 0.040 and 1.007; 95% CI 1.001, 1.013, p = 0.016, respectively). Furthermore, a history of diabetes mellitus was not a significant factor influencing long-term all-cause mortality. Preoperative glucose levels were found to be independently associated with survival outcomes in patients with OVCF who underwent VP. Conversely, diabetes mellitus was not associated with long-term all-cause mortality. Our findings highlight that preoperative hyperglycemia is a risk factor for long-term mortality in this aging surgical population.

摘要

目的

探讨经皮椎体成形术(VP)治疗骨质疏松性椎体压缩骨折(OVCF)患者术前血糖水平与长期全因死亡率之间的关系。

方法

本单中心回顾性研究纳入了 2013 年至 2020 年间因 OVCF 接受 VP 治疗的患者的图表回顾。排除了病理性或多发性骨折或未进行骨密度评估的患者。所有相关信息均从电子病历中收集。所有患者的生存状况均在 2021 年 3 月底确认。采用多变量调整的 Cox 比例风险模型来检查血糖水平对全因死亡率的影响。

结果

共回顾性分析了 131 例患者(平均年龄:75.8±9.3 岁,男性患者:26.7%),中位随访时间为 2.1 年。术前高血糖(风险比:2.668,95%置信区间 [CI]:1.064-6.689;p=0.036)和血糖水平(风险比:2.708,95% CI:1.047-7.003;p=0.040)与全因死亡率升高独立相关。即使在调整了年龄和性别以及可能影响结局的其他因素和合并症后,这种相关性仍然显著(风险比:1.007,95% CI:1.002-1.012;p=0.006 和 2.708,95% CI:1.047-7.003,p=0.040)。此外,糖尿病史不是影响长期全因死亡率的重要因素。

结论

术前血糖水平与接受 VP 治疗的 OVCF 患者的生存结局独立相关。相反,糖尿病与长期全因死亡率无关。我们的研究结果表明,术前高血糖是该老年手术人群长期死亡率的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0592/11365986/bdb33c53a895/41598_2024_71467_Fig1_HTML.jpg

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