The Relationship Between Intraoperative Blood Glucose Level And Postoperative Infections,hospital Length Of Stay And Hospitalization Expenses In Non-diabetic Patients In Gastrointestinal Surgery

Objective:To study the influence between hyperglycemia in the intraoperative period and postoperative infections,hospital length of stay and hospitalization expenses in patients with gastrointestinal surgery who undiagnosed diabetes.Methods: To review the clinical data of 400 cases of non-diabetic patients who were treated by surgery in Fujian Provincial Hospital in December October 2015 to June 2017,and to summarize and analyze their gender,age,intraoperative blood sugar inblood gas analysis,postoperative infections,total length of stay and hospitalization expenses.And to investigate the relationships between blood glucose level and postoperative infections,hospital length of stay and hospitalization expenses in non-diabetic patients in gastrointestinal surgery.Results: In 400 cases of non-diabetic patients undergoing digestive tract related surgery,all the patients were divided into two groups according to whether infections occurred after operations.The blood glucose levels,hospitalization costs and hospitalization days in the postoperative infections group were significantly higher than those no have infections occurred after operations,and there was no significant difference in age and sex between the two groups.Logistic regression analysis showed that intraoperative blood glucose was the risk factor of postoperative infections.The predictive value of intraoperative blood glucose for postoperative infections was evaluated by ROC curve analysis: the area under the curve was 0.575(95%CI 0.513-0.637,P<0.05)and the maximum Yorden index was 6.575mmol/L,the sensitivity was 46.6% and the specificity was 67.3%,and was demonstrated that intraoperative blood glucose >6.575mmol/L increased postoperative infections.Multiple stepwise regression analysis of hospitalization days showed that postoperative infection was a risk factor,and multivariate linear regression analysis of total hospitalization expenses shows that age,postoperative infection and hospitalization days as risk factors.Compared with the average hospitalization duration and daily average cost of the postoperative infection group and the general section during the period of 2015.10-2017.06,the average length of hospital stay increased by 15 days,and the hospitalization cost increased by about 9666 yuan.The scattered plot trend analysis of blood glucose and hospitalization expenses and hospitalization days showed that there are possible positive correlations between blood glucose and hospitalization days and hospitalization expenses.Conclusion: For non-diabetic patients undergoing digestive system related surgery,the intraoperative blood glucose level > 6.575mmol/L could increase the incidence of postoperative infections,prolong the length of hospital stay and increase the cost of hospitalization.It was suggested that intraoperative blood glucose monitoring should be strengthened clinically,and interventions should be carried out if necessary to maintain intraoperative blood glucose at near normal levels to improve prognosis.