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. 2022 May 10;22(1):167.
doi: 10.1186/s12893-022-01601-3.

Development and validation of a prediction model of perioperative hypoglycemia risk in patients with type 2 diabetes undergoing elective surgery

Huiwu Han  1   2   3 , Juan Lai  4   5   6 , Cheng Yan  7 , Xing Li  7 , Shuoting Hu  7 , Yan He  7 , Hong Li  8
Affiliations

Development and validation of a prediction model of perioperative hypoglycemia risk in patients with type 2 diabetes undergoing elective surgery

Huiwu Han et al. BMC Surg. .

Abstract

Aim: To develop and validate a prediction model to evaluate the perioperative hypoglycemia risk in hospitalized type 2 diabetes mellitus (T2DM) patients undergoing elective surgery.

Methods: We retrospectively analyzed the electronic medical records of 1410 T2DM patients who had been hospitalized and undergone elective surgery. Regression analysis was used to develop a predictive model for perioperative hypoglycemia risk. The receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow test were used to verify the model.

Results: Our study showed an incidence of 10.7% for level 1 hypoglycemia and 1.8% for level 2 severe hypoglycemia during the perioperative period. A perioperative hypoglycemic risk prediction model was developed that was mainly composed of four predictors: duration of diabetes ≥ 10 year, body mass index (BMI) < 18.5 kg/m2, standard deviation of blood glucose (SDBG) ≥ 3.0 mmol/L, and preoperative hypoglycemic regimen of insulin subcutaneous. Based on this model, patients were categorized into three groups: low, medium, and high risk. Internal validation of the prediction model showed high discrimination (ROC statistic = 0.715) and good calibration (no significant differences between predicted and observed risk: Pearson χ2 goodness-of-fit P = 0.765).

Conclusions: The perioperative hypoglycemic risk prediction model categorizes the risk of hypoglycemia using only four predictors and shows good reliability and validity. The model serves as a favorable tool for clinicians to predict hypoglycemic risk and guide future interventions to reduce hypoglycemia risk.

Keywords: Elective surgery; Hypoglycemia; Perioperative period; Risk prediction model; Type 2 diabetes mellitus (T2DM).

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Conflict of interest statement

There is no conflict of interest in the study.

Figures

Fig. 1
Fig. 1
ROC curve of perioperative hypoglycemia probability in hospitalized T2DM patients undergoing elective surgery
See this image and copyright information in PMC

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