机构:[a]Department of Endocrinology, Chinese PLA General Hospital,[b]Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing,[c]Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming,昆明医科大学附属第一医院[d]Department of Endocrinology, Chinese PLA 307 Hospital, Beijing, China.
Factors that may result in the occurrence of adverse clinical events in diabetic patients during the postoperative period are not entirely clear. This study evaluated factors that may cause adverse events following elective orthopedic or general surgery. Patients with diabetes who underwent orthopedic or general surgery between January 2010 and October 2015 were retrospectively selected from the General Hospital of People's Liberation Army database. Factors associated with postoperative adverse events were analyzed using multivariable logistic regression. Among 1525 patients included, mean age was 63.5 +/- 10.8 years and mean duration of diabetes was 8.8 +/- 6.6 years. Among them, 49.9% underwent orthopedic surgery and 50.1% underwent general surgery. Postoperatively, 118 (7.7%) patients had adverse events, including delayed extubation (n=43, 36.4%), circulatory disorder (n=15, 12.7%), respiratory and circulatory abnormalities (n=23, 19.5%), nonhealing of the incision (n=11, 9.3%), infections at other sites (n=15, 12.7%), other complications (n=8, 6.8%), and death (n=3, 2.5%). Multivariable regression analysis showed that age > 65 years old [odds ratio (OR)=2.23, 95% confidence interval (CI): 1.25-3.98], male sex (OR=2.14, 95% CI: 1.24-3.38), postoperative peripheral blood glucose (OR=1.13, 95% CI: 1.13-1.82), diabetic complications (OR=2.41, 95% CI: 1.36-4.28), abnormal kidney function (OR=2.73, 95% CI: 1.13-6.58) and general surgery (OR=1.48, 95% CI: 1.11-5.26) were associated with the occurrence of postoperative adverse events. In patients with diabetes undergoing intermediate or major elective surgery, older age, male sex, high postoperative peripheral blood glucose, diabetic complications, abnormal kidney function, and general surgery type were associated with the occurrence of postoperative adverse events.
基金:
This study was supported by Beijing Municipal Science & Technology
Commission (Project No. D141107005314004).
第一作者机构:[a]Department of Endocrinology, Chinese PLA General Hospital,[b]Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing,
通讯作者:
通讯机构:[*1]Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
推荐引用方式(GB/T 7714):
Jinjing Wang,Kang Chen,Xueqiong Li,et al.Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery[J].MEDICINE.2019,98(14):doi:10.1097/MD.0000000000015089.
APA:
Jinjing Wang,Kang Chen,Xueqiong Li,Xinye Jin,Ping An...&Yiming Mu.(2019).Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery.MEDICINE,98,(14)
MLA:
Jinjing Wang,et al."Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery".MEDICINE 98..14(2019)