Admission Hyperglycemia Is a Risk Factor for Deep Surgical-Site Infection in Orthopaedic Trauma Patients. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Anderson, Braden M.; Wise, Brent T.; Joshi, Manjari; Castillo, Renan; O'Toole, Robert V.; Richards, Justin E.
• Is Part Of: Journal of orthopaedic trauma. Volume 35:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: glucose -- hyperglycemia -- surgical site infection; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002101
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To evaluate the association of admission blood glucose ≥200 mg/dL and surgical site infection in orthopaedic trauma surgery. Design: Retrospective, case control study. Setting: Academic trauma center. Patients: Four hundred sixty-five nondiabetic, noncritically ill orthopaedic trauma patients with an extremity, pelvic, or acetabular fracture and requiring open reduction and internal fixation or intramedullary nailing. Intervention: None. Main Outcome Measurements: Ninety-day deep surgical site infection. Results: Admission blood glucose ≥200 mg/dL was significantly associated with the primary outcome (8/128, 6.3% vs. 35/337, 1.8%; P = 0.01). Multivariable logistic regression modeling demonstrated that admission blood glucose ≥200 mg/dL was a significant risk factor for deep surgical site infections [odds ratio (OR): 4.7, 95% confidence interval (CI) 1.4–15.7], after controlling for male gender (OR: 1.8, 95% CI: 1.1–3.1), prior drug or alcohol abuse (OR: 1.9, 95% CI 0.9–4.0), open fracture (OR: 6.4, 95% CI 3.7–11.0), and fracture region (upper extremity OR: reference; pelvis/hip OR: 3.9, 95% CI 1.6–9.7; femur OR: 2.0, 95% CI 0.88–4.8; tibia/ankle OR: 3.3, 95% CI 1.7–6.2; and foot OR: 2.7, 95% CI 1.2–6.3). Conclusions: Admission glucose ≥200 mg/dL was a significant independent risk factor for 90-day deep surgical site infections in orthopaedic trauma patients and may serve as an important marker for infection risk. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.