Navigation Links
High blood sugar, obesity increase risk for surgical site infection
Date:7/25/2012

Two recent studies in the July issues of the Journal of Bone and Joint Surgery (JBJS) looked at surgical site infections and hyperglycemia, the technical term for high blood glucose, or high blood sugar. According to the first study "Relationship of Hyperglycemia and Surgical-Site Infection in Orthopaedic Surgery," high blood sugar is a concern during the post-traumatic and post-operative period and it may help to preoperatively identify a population of patients with musculoskeletal injuries who are at significant risk for infectious complications.

Nearly, one-third of patients who are admitted to the hospital without a history of diabetes have hyperglycemia, which is associated with a longer hospital stay, higher rates of admission to the intensive care unit (ICU), and increased mortality.

Study authors reviewed data on patients 18 years or older who had isolated orthopaedic injuries requiring acute operative intervention. Patients diagnosed with diabetes or who were in the ICU were not included in the study.

Of 790 patients, there were 268 open fractures (if the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone), and 21 surgical-site infections (SSIs) at 30-day follow-up. Age, race, comorbidities, injury severity, and blood transfusion were not associated with SSI at 30 days.

Specific study details: SSIs developed in 13 of 294 patients (4.4 percent) who had more than one glucose value greater than or equal to 200 mg/dL and 8 of 496 patients (1.6 percent) without more than one glucose value greater than or equal to 200 mg/dL. The authors concluded that hyperglycemia was an independent risk factor for thirty-day SSI in orthopaedic trauma patients without a history of diabetes.

This study suggests that recognition of the relationship between hyperglycemia and infectious complications may substantially influence post-operative care of orthopaedic patients. Large, prospective, randomized studies are necessary to further delineate this relationship.

A second study featured in the July 18 issue of JBJS, found that diabetes and morbid obesity increased the risk of infection following hip and knee replacement. Authors of "Obesity, Diabetes, and Preoperative Hyperglycemia as Predictors of Periprosthetic Joint Infection" analyzed 7,181 hip and knee replacements and found that 52 post-operative joint infections occurred within the first year, and that the infection rate increased from a .37 percent in patients with a normal body index to 4.66 percent in the morbidly obese group. Normal BMI was defined as a body mass index (BMI) of less than 25, while morbid obesity was defined as more than 40. (BMI is a calculation that is determined using height and weight).

Diabetes more than doubled the risk of a post-operative joint infection independent of obesity. The infection rate was the highest in morbidly obese, diabetic patients.

For patients without a diagnosis of diabetes at the time of surgery, there was a trend toward a higher infection rate in association with a pre-operative glucose level of more than 124 mg/dL.

The authors suggest that identifying and/or treating hyperglycemic patients preoperatively, especially if they are obese, would help patients achieve a better outcome by avoiding complications caused by infection. In addition, identifying patients with undiagnosed diabetes would be important for their overall long-term prognosis. Authors further conclude that the benefits of joint replacement should be carefully weighed against the incidence of postoperative infection, especially among the morbidly obese patients.


'/>"/>

Contact: Lauren P Riley
pearson@aaos.org
947-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

Related medicine news :

1. ASH launches multi-million-dollar grant program to support critical blood disease research
2. New angioplasty procedure improves blood flow in blocked arteries to extremities
3. Researchers unfold the mechanisms underlying blood disorders
4. Many Teens With High Blood Pressure Dont Get Needed Tests
5. Bloodstream scavenger inhibits clotting without increased bleeding
6. HIV suppression not as good as previously thought, largest study of viral-load blood tests show
7. Blood condition is highly predictive of graft failure in pediatric kidney transplant
8. Scientists Say Blood Test May Help Predict Alzheimers
9. Are cardiac risk factors linked to less blood flow to the brain?
10. High Blood Pressure May Protect Some Frail Elderly: Study
11. Neurons derived from cord blood cells may represent new therapeutic option
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/28/2017)... ... ... Thank you to all who attended Capio Partners Winter 2017 Healthcare Leadership Symposium in ... and offered an opportunity to collaborate and network with healthcare colleagues across the United ... gathered for a lively discussion on trends and issues that healthcare leaders will face ...
(Date:3/28/2017)... ... ... that reveals the mystery of Kevin’s purpose. “A Prophets Bones” is the creation of published ... him that he had neglected to do, but this was from God and there was ... would have felt themselves to be special and better than others due to the fact ...
(Date:3/27/2017)... ... ... New patients who have sleep apnea in Aurora, CO, can now ... Sleep apnea is often left untreated because patients are not familiar with common symptoms ... , Dr. Braasch seeks to raise awareness of sleep apnea in Aurora, CO, and ...
(Date:3/27/2017)... ... March 27, 2017 , ... Drs. Bruce Trimble and Michelle ... requiring a referral. Trimble Dental offers a variety of services to meet each ... Whether patients have discolored, crooked or missing teeth in Eau Claire, WI, Drs. ...
(Date:3/27/2017)... ... ... Drs. Justin Kolnick, Kara Diamond, Randall Barton, Keith Hope and Bilal Chaudhry ... this treatment plays in protecting oral health, along with the benefits of receiving ... a root canal in White Plains, NY or their second location in Mt. Kisco, ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... March 27, 2017  BERG, a biopharmaceutical ... biological research approach, today announced that the ... discovery of new data using a cold-induced ... fat metabolism. Joslin Diabetes Center led the ... platform for analysis of samples.  The findings ...
(Date:3/27/2017)... , March 27, 2017  iCAD (Nasdaq: ... workflow solutions and radiation therapy for the early ... PowerLook® Tomo Detection received Premarket Approval (PMA) from ... Tomo Detection is a first-of-its-kind, concurrent-read computer aided ... is the latest innovation available on the PowerLook® ...
(Date:3/27/2017)...  Impax Laboratories, Inc. (NASDAQ: IPXL)today announced that its ... as Impax,s President and Chief Executive Officer and ... 2017. Mr. Bisaro will succeed J. Kevin Buchi ... Executive Officer since December of 2016. ... Mr. Bisaro, 56, is an accomplished global business leader ...
Breaking Medicine Technology: