Stress-Induced Hyperglycemia is a Risk Factor for Surgical-Site Infections in Nondiabetic Patients with Open Leg Fractures.
Journal
Advances in orthopedics
ISSN: 2090-3464
Titre abrégé: Adv Orthop
Pays: Egypt
ID NLM: 101565129
Informations de publication
Date de publication:
2023
2023
Historique:
received:
17
05
2023
revised:
24
09
2023
accepted:
04
10
2023
medline:
3
11
2023
pubmed:
3
11
2023
entrez:
3
11
2023
Statut:
epublish
Résumé
Nondiabetic patients with open leg fractures who have elevated blood glucose levels on arrival in the emergency department have an increased risk of surgical-site infections (SSIs). This study evaluates the association between the incidence of SSIs in nondiabetic patients with an open leg fracture and blood glucose levels registered on arrival in the ER. We also analyzed the correlation between patients' days of hospital stay and the incidence of SSIs and the time elapsed between the damage control with external fixation and final fixation and the incidence of SSI. We retrospectively studied nondiabetic patients admitted to our emergency unit from 2017 to 2021 with a diagnosis of open leg fracture consecutively treated. Based on the diagnosis of SSIs, all enrolled patients were divided into two groups based on the developed (group A) or not developed (group B) SSIs within 1 year after surgery. All patients enrolled in the study underwent damage control within 24 hours after admission to the ER. At stabilization of general clinical and local wound conditions, all patients underwent definitive surgery. We enrolled 80 patients. In group A, glycemia on arrival in the ER was on average 148.35 ± 19.59 mg/dl, and in group B, it was 122.61 ± 22.22 mg/dl ( Our findings show that nondiabetic patients with SIH have a significantly increased risk of SSIs compared to patients without SIH within 1 year after surgery. Patients with open leg fractures with SIH have a significantly higher average hospital stay than patients without SIH. Further studies are needed to confirm 132 mg/dl of blood glucose levels as a value to stratify the risk of SSIs in these patients.
Sections du résumé
Background
UNASSIGNED
Nondiabetic patients with open leg fractures who have elevated blood glucose levels on arrival in the emergency department have an increased risk of surgical-site infections (SSIs).
Objective
UNASSIGNED
This study evaluates the association between the incidence of SSIs in nondiabetic patients with an open leg fracture and blood glucose levels registered on arrival in the ER. We also analyzed the correlation between patients' days of hospital stay and the incidence of SSIs and the time elapsed between the damage control with external fixation and final fixation and the incidence of SSI.
Methods
UNASSIGNED
We retrospectively studied nondiabetic patients admitted to our emergency unit from 2017 to 2021 with a diagnosis of open leg fracture consecutively treated. Based on the diagnosis of SSIs, all enrolled patients were divided into two groups based on the developed (group A) or not developed (group B) SSIs within 1 year after surgery. All patients enrolled in the study underwent damage control within 24 hours after admission to the ER. At stabilization of general clinical and local wound conditions, all patients underwent definitive surgery.
Results
UNASSIGNED
We enrolled 80 patients. In group A, glycemia on arrival in the ER was on average 148.35 ± 19.59 mg/dl, and in group B, it was 122.61 ± 22.22 mg/dl (
Conclusion
UNASSIGNED
Our findings show that nondiabetic patients with SIH have a significantly increased risk of SSIs compared to patients without SIH within 1 year after surgery. Patients with open leg fractures with SIH have a significantly higher average hospital stay than patients without SIH. Further studies are needed to confirm 132 mg/dl of blood glucose levels as a value to stratify the risk of SSIs in these patients.
Identifiants
pubmed: 37920443
doi: 10.1155/2023/6695648
pmc: PMC10620027
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6695648Informations de copyright
Copyright © 2023 Luigi Cianni et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Am J Infect Control. 1992 Oct;20(5):271-4
pubmed: 1332552
Int J Environ Res Public Health. 2017 Sep 30;14(10):
pubmed: 28974008
Int Orthop. 2017 Oct;41(10):1965-1982
pubmed: 28744800
BMJ. 2013 Jul 31;347:f4305
pubmed: 23903454
Crit Care. 2016 Sep 27;20(1):301
pubmed: 27677709
Malays J Med Sci. 2013 Oct;20(5):47-53
pubmed: 24643115
J Hosp Infect. 2009 Jul;72(3):193-201
pubmed: 19482375
J Trauma. 2005 Jul;59(1):80-3
pubmed: 16096543
J Orthop Trauma. 2016 Jul;30(7):397-402
pubmed: 26978135
Strategies Trauma Limb Reconstr. 2014 Nov;9(3):167-71
pubmed: 25526857
N Engl J Med. 2009 Mar 26;360(13):1283-97
pubmed: 19318384
Injury. 2012 Jun;43(6):891-7
pubmed: 22204774
Injury. 2015 Apr;46(4):746-50
pubmed: 25636535
Ann Surg. 2010 Oct;252(4):597-602
pubmed: 20881765
Injury. 2020 May;51 Suppl 2:S57-S63
pubmed: 31679836
J Biol Regul Homeost Agents. 2020 May-Jun;34(3 Suppl. 2):63-69. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOT
pubmed: 32856442
J Trauma. 2003 Nov;55(5):949-54
pubmed: 14608171
J Orthop Trauma. 2013 Jan;27(1):16-21
pubmed: 22588532
Curr Geriatr Rep. 2014 Mar 1;3(1):48-55
pubmed: 25431751
J Trauma Acute Care Surg. 2014 Apr;76(4):1070-5
pubmed: 24662873
J Trauma Acute Care Surg. 2022 Sep 1;93(3):316-322
pubmed: 35234715
J Bone Joint Surg Am. 1976 Jun;58(4):453-8
pubmed: 773941
Int J Surg. 2018 Aug;56:124-132
pubmed: 29929022
Diabetes Care. 2021 Jan;44(Suppl 1):S15-S33
pubmed: 33298413
J Diabetes Sci Technol. 2011 Mar 01;5(2):412-8
pubmed: 21527113
Injury. 1998 Sep;29(7):529-34
pubmed: 10193496
Injury. 2017 Oct;48(10):2266-2269
pubmed: 28729006
Ann Surg. 2008 Oct;248(4):585-91
pubmed: 18936571
J Am Acad Orthop Surg Glob Res Rev. 2022 Sep 23;6(9):
pubmed: 36155604
Euro Surveill. 2018 Nov;23(46):
pubmed: 30458912
Arch Surg. 2010 Sep;145(9):858-64
pubmed: 20855756
Bone Joint J. 2018 Nov;100-B(11):1506-1510
pubmed: 30418053
Am Surg. 2005 Feb;71(2):171-4
pubmed: 16022019
Diabet Med. 1997 Jan;14(1):29-34
pubmed: 9017350
PLoS One. 2013 Jun 27;8(6):e67167
pubmed: 23826224
J Am Acad Orthop Surg. 2020 Aug 15;28(16):661-670
pubmed: 32769721
Diabetes Care. 1998 Feb;21(2):246-9
pubmed: 9539990
Unfallchirurg. 2017 Jun;120(6):472-485
pubmed: 28573554
J Am Acad Orthop Surg. 2010 Jul;18(7):426-35
pubmed: 20595135
N Engl J Med. 2015 Dec 31;373(27):2629-41
pubmed: 26448371
Infect Dis Clin North Am. 2017 Jun;31(2):339-352
pubmed: 28292542
Int J Environ Res Public Health. 2018 May 15;15(5):
pubmed: 29762485
J Orthop Trauma. 2005 Mar;19(3):151-7
pubmed: 15758667
Cureus. 2022 Jul 10;14(7):e26714
pubmed: 35959169
Antibiotics (Basel). 2021 Dec 10;10(12):
pubmed: 34943725
J Orthop Traumatol. 2015 Sep;16(3):195-201
pubmed: 25720585
J Bone Joint Surg Am. 2012 Jul 3;94(13):1181-6
pubmed: 22760385
PLoS One. 2013 Dec 18;8(12):e83743
pubmed: 24367612
J Orthop Trauma. 2010 Dec;24(12):752-6
pubmed: 21076247
Bone Joint J. 2014 Mar;96-B(3):379-84
pubmed: 24589795
J Crit Care. 2020 Feb;55:149-156
pubmed: 31731174
J Biol Regul Homeost Agents. 2020 May-Jun;34(3 Suppl. 2):77-81. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOT
pubmed: 32856444