血糖间隙预测老年全髋关节置换术患者围手术期输血的临床效能OA

Objective To explore the clinical efficacy of blood glucose gap in predicting perioperative blood transfusion in elderly patients undergoing total hip replacement(THR).Methods A total of 110 elderly patients undergoing THR admitted to Daxing District People's Hospital,Beijing from January 2022 to December 2024 were enrolled.According to whether red blood cells were transfused during the perioperative period,the patients were divided into the transfusion group(n=32)and the non-transfusion group(n=78).Multivariate stepwise logistic regression analysis was used to identify the influencing factors for perioperative blood transfusion in elderly THR patients;receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of blood glucose gap for perioperative blood transfusion in elderly THR patients.Results Compared with the non-transfusion group,the transfusion group had significantly higher age,proportion of American Society of Anesthesiologists physical status classificationⅢ-Ⅳ,intraoperative blood loss,postoperative drainage volume,operation duration,and blood glucose gap level,while having significantly lower body mass index,hemoglobin,and hematocrit,with statistically significant differences(P<0.05).Multivariate stepwise logistic regression analysis showed that advanced age and high blood glucose gap level were independent risk factors for perioperative blood transfusion in elderly THR patients(OR=1.972,95%CI:1.419-2.741,P<0.001;OR=2.614,95%CI:1.756-3.892,P<0.001),and high hemoglobin level was a protective factor(OR=0.434,95%CI:0.298-0.632,P<0.001).ROC curve analysis showed that the areas under the curve(AUC)of age,hemoglobin,and blood glucose gap for predicting perioperative blood transfusion in elderly THR patients were 0.635,0.862,and 0.903,respectively.The AUC of blood glucose gap was higher than that of age and hemoglobin(P<0.05),indicating that blood glucose gap had the best predictive value.Conclusion Blood glucose gap has a high predictive value for perioperative blood transfusion in elderly THR patients and can provide an important basis for clinical blood transfusion decisions.