术前血糖水平对急性A型主动脉夹层患者院内死亡的预测价值

The Predictive Value of Postoperative Blood Glucose Levels for In-Hospital Mortality in Patients with Acute Type A Aortic Dissection

摘要: 目的：探索术前血糖水平对急性A型主动脉夹层患者术后死亡的预测价值，并通过倾向性匹配分析进一步验证血糖的预测价值。方法：本研究纳入了309例接受手术治疗的急性A型主动脉夹层患者。采用多因素逻辑回归分析，探索血糖与院内死亡的关联；采用受试者工作特征曲线下面积(AUC)评估模型的判别能力；通过约登指数计算最佳截断值，并进行倾向性匹配分析。结果：术前血糖水平与院内死亡独立相关(P < 0.005)，血糖模型的判别能力良好(AUC= 0.83)。结论：术前血糖水平对急性A型主动脉夹层患者预后有预测价值。

Abstract: Objective: To investigate the predictive value of preoperative blood glucose for postoperative mortality in patients with acute type A aortic dissection undergoing surgical treatment, and further validate the predictive value of blood glucose levels through propensity score matching. Methods: This study included 309 patients with acute type A aortic dissection who underwent surgical treatment. Logistic regression analysis was used to investigate the association between blood glucose levels and in-hospital mortality; the area under the receiver operating characteristic (ROC) curve (AUC) was used to assess the model’s discriminatory ability; the optimal cutoff value was determined using the Youden index, and propensity score matching analysis was performed. Results: Preoperative blood glucose levels were independently associated with in-hospital mortality (P < 0.005), and the blood glucose model demonstrated good predictive ability (AUC = 0.83). Conclusion: Preoperative blood glucose levels have predictive value for the prognosis of patients with acute type A aortic dissection.