High Glucose in Non-Diabetic Patients Increase Infection Risk in Leg Fractures

A recent study published in Advances in Orthopedics found a significant association between elevated blood glucose levels and an elevated risk of surgical-site infections (SSIs) in nondiabetic patients with open leg fractures. The research also found the potential impact of prolonged hospital stays in such cases.

This study examined the connection between SSI occurrence in nondiabetic patients with open leg fractures and their blood glucose levels upon arrival in the emergency room. Additionally, the study explored the relationship between hospitalization duration and SSI incidence and the timing of fixation procedures in relation to SSI development. 

The research retrospectively focused on nondiabetic patients treated in the emergency department between 2017 and 2021 for open leg fractures. Patients were categorized into two groups: those who developed SSIs (group A) and those who did not (group B) within one year after surgery. All patients underwent damage control procedures within 24 hours of admission to the ER and definitive surgery upon stabilization of their condition.

A total of 80 patients were included in the study. In group A, the average blood glucose level upon ER arrival was 148.35 ± 19.59 mg/dl, compared to 122.61 ± 22.22 mg/dl in group B (p-value: 0.0001). In group A, the average blood glucose on the first postoperative day was 113.81 ± 21.07 mg/dl, while in group B, it was 99.02 ± 17.60 mg/dl (p-value: 0.001).

Moreover, the average hospital stay in group A was notably longer at 57.92 ± 42.43 days, compared to 18.41 ± 14.21 days in group B (p-value: 0.01). By utilizing statistical analysis, the study identified a blood glucose threshold of 132 mg/dl as a potential indicator of heightened SSI risk.

This study highlights the substantial risk of SSIs among nondiabetic patients with elevated blood glucose levels, as well as the extended hospital stays associated with this condition. It suggests that a blood glucose level of 132 mg/dl might be a valuable marker to assess the SSI risk in these patients.

Reference:

Cianni, L., Caredda, M., De Fazio, A., Basilico, M., Greco, T., Cazzato, G., Perisano, C., Maccauro, G., & Vitiello, R. (2023). Stress-Induced Hyperglycemia is a Risk Factor for Surgical-Site Infections in Nondiabetic Patients with Open Leg Fractures. In A. L. Carl (Ed.), Advances in Orthopedics (Vol. 2023, pp. 1–8). Hindawi Limited. https://doi.org/10.1155/2023/6695648