Diabetes. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Bomberg, Hagen; Kubulus, Christine; List, Franka; Albert, Noemi; Schmitt, Kathrin; Gräber, Stefan; Kessler, Paul; Steinfeldt, Thorsten; Standl, Thomas; Gottschalk, André; Wirtz, Stefan P.; Burgard, Gerald; Geiger, Peter; Spies, Claudia D.; Volk, Thomas
• Is Part Of: Regional anesthesia and pain medicine. Volume 40:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1097/AAP.0000000000000196
• Languages: English
• ISSNs: 1098-7339

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background and Objectives</title> <p>The incidence of infectious complications associated with continuous regional anesthesia techniques is a matter of concern. Our objective was to determine whether patients suffering from diabetes are at an increased risk of catheter-related infectious complications.</p> </sec> <sec> <title>Methods</title> <p>The German Network for Regional Anaesthesia database was analyzed between 2007 and 2012. After proof of plausibility, data of 36, 881 patients undergoing continuous regional anesthesia were grouped in I: no diabetes (n = 32, 891) and II: any diabetes (n = 3990). The analysis focused on catheter-related infections after strict definition. Differences among the groups were tested with <italic>t</italic> and χ<sup>2</sup> tests. Odds ratios were calculated with logistic regression and adjusted for potential confounders.</p> </sec> <sec> <title>Results</title> <p>Patients with a diagnosis of diabetes had an increased incidence of catheter-related infections (no diabetes 3.0% vs any diabetes 4.2%; <italic>P</italic> < 0.001). Among all patients, diabetes remained an independent risk factor for infections for all sites after the adjustment for potential confounders (odds ratio [OR] = 1.26; 95% confidence interval [95% CI], 1.02–1.55; <italic>P</italic> = 0.036). The risk of infection was significantly increased in peripheral catheters only in the lower limb (adjusted OR = 2.42; 95% CI, 1.05–5.57; <italic>P</italic> = 0.039). If neuraxial catheters were used, the risk was significantly increased only in lumbar epidural (adjusted OR = 2.09; 95% CI, 1.18–3.73; <italic>P</italic> = 0.012) for diabetic patients compared with nondiabetic patients.</p> </sec> <sec> <title>Conclusions</title> <p>The presence of diabetes is associated with an increased risk for catheter-related infections in lower limb and lumbar epidural. Specific care should be taken to avoid and detect infections in this population.</p> </sec> </abstract>