Correlation between admission hyperglycemia and postoperative pneumonia after hip fracture surgery: A propensity score-matched study.

Autor: Luo Y; Department of Orthopedics, Zigong First People's Hospital, No. 42, Yizhi Road, Shangyihao Street, Zigong, 643000, Sichuan Province, People's Republic of China., Ni X; Department of Orthopedics, Zigong Fourth People's Hospital, Zigong, China., Yao W; Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China., Wang W; Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China., Li Y; Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China., Lv Q; Department of Endocrinology, Dandong Central Hospital, China Medical University, Dandong, China., Ding W; Department of Orthopedics, Dandong Central Hospital, China Medical University, Dandong, China., Tang W; Department of Orthopedics, Zigong First People's Hospital, No. 42, Yizhi Road, Shangyihao Street, Zigong, 643000, Sichuan Province, People's Republic of China. wanyuntang8@gmail.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Dec 02; Vol. 14 (1), pp. 29915. Date of Electronic Publication: 2024 Dec 02.
DOI: 10.1038/s41598-024-78343-0
Abstrakt: The association between admission hyperglycemia and postoperative pneumonia is unclear in hip fracture patients. We investigated the relationship between admission hyperglycemia and postoperative pneumonia after hip fracture surgery. This retrospective study analyzed data from 1,267 geriatric patients admitted for hip fractures. Patients were categorized into normoglycemic (< 6.10 mmol/L) and hyperglycemic (≥ 6.10 mmol/L) groups based on admission blood glucose levels. Multivariable logistic regression and propensity score matching (PSM) were used to control for potential confounding variables and estimate adjusted odds ratios and 95% confidence intervals for postoperative pneumonia (POP). We also examined the dose-dependent link between admission blood glucose and the likelihood of developing POP. Further analyses evaluated whether admission hyperglycemia has differing impacts on POP outcomes among hip fracture patients without diabetes (NDM) versus those with diabetes (DM). Additionally, subgroup analyses were conducted to assess the influence of other factors on the relationship between admission blood glucose and POP occurrence. Patients with admission hyperglycemia had significantly higher rates of POP compared to normoglycemic patients, both before (13.2% vs. 4.8%) and after (10.1% vs. 5.8%) PSM. Admission hyperglycemia is an independent risk factor of POP (OR = 2.64, 95% CI: 1.42-4.92, p = 0.002). The association persisted after PSM(OR = 2.90, 95% CI: 1.35-3.86, p = 0.016). Additionally, higher blood glucose levels correlated with a greater likelihood of developing POP. A dose-response relationship was observed between blood glucose levels and the risk of POP. Non-diabetic group patients with hyperglycemia were at higher risk of POP than diabetic group patients with hyperglycemia. Finally, the relationship between hyperglycemia and increased POP risk is modulated and influenced by the ASA classification of the patient. Admission hyperglycemia is an independent risk factor for POP after hip fracture surgery in the elderly. There is a dose-response relationship between admission blood glucose and the occurrence of POP, which is more significant in non-diabetic patients than diabetic patients.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Dandong Central Hospital (No. DDZX-202401103) and conducted by the ethical principles outlined in the Helsinki Declaration of 1964 and its subsequent amendments. Written informed consent for participation was not required from the participants or the participants’ legal guardians/next of kin in accordance with the national legislation and institutional requirements. Consent for publication: We have obtained consent for publication from all participants.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje