The predictive value of stress-induced hyperglycemia parameters for delayed healing after tibial fracture post-surgery.

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2024-10-16 DOI:10.1186/s13018-024-05138-4

Xiang Ji, Dunxu Zhao, Zetuan Xin, Hai Feng, Zhiyong Huang

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引用次数: 0

Abstract

Purpose: The objective of this retrospective cohort study was to investigate the predictive value of stress-induced hyperglycemia parameters for delayed healing after tibial fracture post-surgery.

Methods: A cohort of 108 participants who underwent surgical intervention for tibial fractures caused by trauma was included in this retrospective study. Data collected from electronic medical records encompassed demographic characteristics, bone healing assessments, stress-induced hyperglycemia parameters, inflammatory markers, and stress-related hormones. Comparative analyses, correlation analyses, univariate logistic regression analyses, and receiver operating characteristic (ROC) curve analyses were conducted to assess the predictive value of the studied parameters.

Results: The delayed healing group exhibited higher levels of fasting blood glucose, postprandial glucose, and HbA1c, as well as elevated levels of inflammatory markers and stress-related hormones compared to the normal healing group. Correlation analysis and logistic regression demonstrated positive associations between stress-induced hyperglycemia parameters, inflammatory markers, stress-related hormones, and delayed union of tibial fractures (R2: 0.183 ~ 0.403;OR: 1.091 ~ 16.332). ROC curve analysis revealed high area under the curve (AUC = 0.911) values for stress-induced hyperglycemia parameters, indicating their potential as predictive markers for delayed healing. Multivariate regression analysis further substantiated the predictive capability of stress-induced hyperglycemia parameters.

Conclusion: The study findings highlight the complex interplay between stress-induced hyperglycemia, inflammatory response, and bone healing outcomes in patients undergoing surgical intervention for tibial fractures. The identification of stress-induced hyperglycemia parameters as potential predictive markers for delayed healing after tibial fracture surgery offers insights for risk assessment and patient management, emphasizing the need for comprehensive understanding of these factors to optimize postoperative recovery in orthopedic patients.

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应力诱发的高血糖参数对胫骨骨折术后延迟愈合的预测价值。

目的：这项回顾性队列研究旨在探讨应激诱导的高血糖参数对胫骨骨折术后延迟愈合的预测价值：这项回顾性研究共纳入了108名因外伤导致胫骨骨折而接受手术治疗的患者。从电子病历中收集的数据包括人口统计学特征、骨愈合评估、应激诱导的高血糖参数、炎症标志物和应激相关激素。通过比较分析、相关性分析、单变量逻辑回归分析和接收器操作特征曲线（ROC）分析来评估所研究参数的预测价值：结果：与正常愈合组相比，延迟愈合组的空腹血糖、餐后血糖和 HbA1c 水平较高，炎症标志物和应激相关激素水平也有所升高。相关分析和逻辑回归表明，应激诱导的高血糖参数、炎症标志物、应激相关激素与胫骨骨折延迟愈合之间存在正相关（R2：0.183 ~ 0.403；OR：1.091 ~ 16.332）。ROC 曲线分析显示，应激诱导的高血糖参数的曲线下面积（AUC = 0.911）值较高，表明它们有可能成为延迟愈合的预测指标。多变量回归分析进一步证实了应激诱导的高血糖参数的预测能力：研究结果凸显了接受手术治疗的胫骨骨折患者应激诱导的高血糖、炎症反应和骨愈合结果之间复杂的相互作用。应激诱导的高血糖参数被确定为胫骨骨折术后延迟愈合的潜在预测指标，这为风险评估和患者管理提供了启示，强调了全面了解这些因素以优化骨科患者术后恢复的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.