The effect of hyperglycemia and obesity on the condition of patients with closed biliary surgery / 中华内分泌外科杂志

ABSTRACT

Objective:To investigate the effect of different blood glucose and BMI levels on the outcome of closed biliary surgery in diabetic patients.Methods:Clinical data of 424 diabetes admitted to Shanxi Provincial People’s Hospital for closed biliary tract surgery from Jan. 2018 to Jun. 2019 were retrospectively analyzed. According to the fasting blood glucose and BMI levels, the subjects were divided into hyperglycemia and non-hyperglycemia groups and obesity and non-obesity subgroups. The differences of clinical data among different groups were compared and analyzed. Multiple regression analysis was used to analyze the factors of postoperative infection, length and cost of hospitalization.Results:①Compared with the non-hyperglycemia group, the hyperglycemia group had higher BMI, serum creatinine, blood urea nitrogen, blood glucose monitoring rate, glycated hemoglobin detection rate, postoperative infection rate, ICU occupancy rate, length and cost of hospitalization, and lower albumin level, all P<0.05.②The age, fasting blood glucose, serum creatinine, low density lipoprotein, length and cost of hospitalization in the hyperglycemic obese subgroup were all lower than those in the non-obese subgroup, all P<0.05; and the serum creatinine in the obese subgroup was higher than those in the non-obese subgroup ( P<0.05) . ③Logistic analysis revealed that hyperglycemia was an independent risk factor for postoperative infection. For every 1mmol/L increase in fasting blood glucose, the risk of postoperative infection increased by 1.158 times, and albumin was a protective factor for postoperative infection. ④Multiple linear regression analysis showed that hyperglycemia and hypoalbumin were the important factors affecting the length of hospital stay and the increase of hospital cost, all P<0.05. Conclusions:Hyperglycemia is an independent risk factor for postoperative infection and a risk factor for longer hospital stay and higher costs. Obesity is not associated with postoperative infection or longer hospital stay, except for increased serum. Patients with diabetes undergoing closed biliary system surgery need to improve the detection rate of glycated hemoglobin and blood glucose monitoring rate, manage blood glucose reasonably, and control body weight appropriately.