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首页> 外文期刊>Journal of orthopaedic trauma >Stress-induced hyperglycemia as a risk factor for surgical-site infection in nondiabetic orthopedic trauma patients admitted to the intensive care unit
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Stress-induced hyperglycemia as a risk factor for surgical-site infection in nondiabetic orthopedic trauma patients admitted to the intensive care unit

机译：重症监护病房收治的非糖尿病骨科创伤患者中，应激诱发的高血糖是手术部位感染的危险因素

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Objectives: The aim of this study was to evaluate the association between stress-induced hyperglycemia and infectious complications in nondiabetic orthopedic trauma patients admitted to the intensive care unit (ICU). Design: This study was a retrospective review. Setting: The study was conducted at an academic level-1 trauma center. Patients: One hundred and eighty-seven consecutive trauma patients with isolated orthopedic injuries were studied. Intervention: Blood glucose values during initial hospitalization were evaluated. The admission blood glucose (BG) and hyperglycemic index (HGI) were determined for each patient. Main Outcome Measures: Perioperative infectious complications: pneumonia, urinary tract infection (UTI), surgical-site infection (SSI), sepsis were the outcome measures. Result: An average of 21.5 BG values was obtained for each patient. The mean ICU and hospital length of stay was 4.0 ± 4.9 and 10.0 ± 8.1 days, respectively. Infections were recorded in 43 of 187 patients (23.0%) and SSIs specifically documented in 16 patients (8.6%). Open fractures were not associated with SSI (8/83, 9.6% vs. 8/104, 7.7%). There was no difference in admission BG or HGI and infection. However, there was a significant difference in HGI when considering SSI alone (2.1 ± 1.7 vs. 1.2 ± 1.1). Patients with an SSI received a greater amount of blood transfusions (14.9 ± 12.1 vs. 4.9 ± 7.6). No patient was diagnosed with a separate infection (ie, pneumonia, UTI, bacteremia) before SSI. There was no significant difference in injury severity score among patients with an SSI (11.1 ± 4.0 vs. 9.6 ± 3.0). Multivariable regression testing with HGI as a continuous variable demonstrated a significant relationship (odds ratio: 1.8, 95% confidence interval: 1.3-2.5) with SSI after adjusting for blood transfusions (odds ratio: 1.1, 95% confidence interval: 1.1-1.2). Conclusions: Stress-induced hyperglycemia demonstrated a significant independent association with SSIs in nondiabetic orthopedic trauma patients who were admitted to the ICU.
机译：目的：本研究的目的是评估重症监护病房（ICU）收治的非糖尿病骨科创伤患者的应激性高血糖与感染并发症之间的关系。设计：本研究为回顾性审查。地点：该研究是在一级学术创伤中心进行的。患者：研究了一百八十七名连续性创伤患者，这些患者患有孤立的骨科损伤。干预措施：评估了初始住院期间的血糖值。确定每位患者的入院血糖（BG）和高血糖指数（HGI）。主要观察指标：围手术期感染并发症：肺炎，尿路感染（UTI），手术部位感染（SSI），败血症为治疗措施。结果：每位患者平均获得21.5 BG值。平均ICU和住院天数分别为4.0±4.9天和10.0±8.1天。 187位患者中有43位记录了感染（23.0％），而16位患者（8.6％）明确记录了SSI。开放性骨折与SSI无关（8 / 83，9.6％vs. 8 / 104，7.7％）。入院的BG或HGI和感染没有差异。但是，仅考虑SSI时，HGI存在显着差异（2.1±1.7与1.2±1.1）。 SSI患者接受了更多的输血（14.9±12.1比4.9±7.6）。在SSI之前，没有患者被诊断出患有单独的感染（即肺炎，UTI，菌血症）。在SSI患者中，损伤严重程度评分无显着差异（11.1±4.0与9.6±3.0）。调整输血后，以HGI作为连续变量的多变量回归测试显示与SSI有显着关系（几率：1.8，95％置信区间：1.3-2.5）（几率：1.1，95％置信区间：1.1-1.2） 。结论：压力诱发的高血糖在非ICU住院的非糖尿病骨科创伤患者中显示出与SSI显着独立相关。

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