Ni Yan, Hu Cheng-Ming, Li Chao, Zhang Ting, Bao Ying-Xue
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Operation Room, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Front Surg. 2024 Nov 20;11:1476173. doi: 10.3389/fsurg.2024.1476173. eCollection 2024.
This retrospective study aimed to explore the relationship between intraoperative glucose (IG) and the length of hospital stay (LOS) in patients with femoral neck fractures via the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database.
A generalized additive model was performed to explore the relationship between IG levels and LOS. Restricted cubic spline curves were used to analyze the dose-response relationship between IG levels and prolonged LOS (or 7-day LOS). Threshold effect analysis was conducted to assess the key points influencing their association. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were performed to evaluate the predictive performance of IG levels for LOS.
A total of 743 patients with femoral neck fractures were enrolled from the MIMIC-IV database. We found that there was a non-linear relationship between IG and the LOS (or prolonged LOS/>7 days LOS). Moreover, their relationship was still significant even after adjusting for potential confounders. The threshold effect showed that IG was significantly related to a prolonged LOS when it was >137 mg/dl, and IG was significantly related to a 7-day LOS when it was >163 mg/dl. ROC showed that IG had a better function in predicting a 7-day LOS in participants with IG >163 mg/dl than in predicting a prolonged LOS among participants with IG >137 mg/dl. Moreover, the DCA results showed that IG can obtain a favorable net benefit in clinical settings in predicting a 7-day LOS among participants with IG >163 mg/dl.
In summary, there was a non-linear relationship between IG levels and LOS. In patients with IG levels >163 mg/dl, using IG content to predict an LOS >7 days had a good function.
本回顾性研究旨在通过重症监护医学信息数据库-IV（MIMIC-IV）探讨股骨颈骨折患者术中血糖（IG）与住院时间（LOS）之间的关系。
采用广义相加模型探讨IG水平与LOS之间的关系。使用受限立方样条曲线分析IG水平与延长住院时间（或7天住院时间）之间的剂量反应关系。进行阈值效应分析以评估影响它们关联的关键点。绘制受试者工作特征（ROC）曲线和决策曲线分析（DCA）以评估IG水平对LOS的预测性能。
从MIMIC-IV数据库中纳入了743例股骨颈骨折患者。我们发现IG与LOS（或延长住院时间/＞7天住院时间）之间存在非线性关系。此外，即使在调整潜在混杂因素后，它们的关系仍然显著。阈值效应表明，当IG＞137mg/dl时，IG与延长住院时间显著相关；当IG＞163mg/dl时，IG与7天住院时间显著相关。ROC曲线显示，与预测IG＞137mg/dl患者的延长住院时间相比，IG在预测IG＞163mg/dl参与者的7天住院时间方面具有更好的性能。此外，DCA结果表明，在临床环境中，IG在预测IG＞163mg/dl参与者的7天住院时间方面可获得良好的净效益。
总之，IG水平与LOS之间存在非线性关系。在IG水平＞163mg/dl的患者中，使用IG含量预测住院时间＞7天具有良好的性能。
