The Role of Admission Hyperglycaemia as a Risk Factor for Surgical Site Infection in Orthopaedic Trauma Patients

Abstract

Introduction: Acute hyperglycemia following traumatic injury is common. Studies have shown that 20– 30% of trauma patients present following injury with blood glucose values ≥ 200 mg/dL, and that a majority of patients demonstrate values ≥ 150 mg/dL. The relationship between hyperglycemia and adverse outcomes, such as infectious complications, has been well described in the surgical literature. Post-traumatic hyperglycemia is less well-documented in orthopaedic trauma patients. Aim of the Study: The aim of this study was to evaluate the role of admission hyperglycaemia as a risk factor for surgical site infection in orthopaedic trauma patients. Methods: This was a retrospective observational study and was conducted in the Department of Orthopaedics Surgery of Brahmanbaria medical college Hospital, Brahmanbaria, Bangladesh during the period from October, 2020 to October, 2022. We included 130 patients who were admitted to orthopaedics surgery department. Result: Majority of our patients (41.54%) were aged 41-50 years and 65% patients were male compared to female (35%). The mean age was 45.69 ± 22.83 years. Majority (41.54%) of our patients had a preoperative American Society of Anesthesiologists (ASA) classification of II. Majority of patients 36.15% had type 1 open fracture. We found 45 patients with surgical site infection. Admission glucose more than 200 mg/dL was found higher (26.67%) in infected group. Among the hyperglycemic patients 36.36% were classified as ASA III & the surgical site infection for 30 days was found 54.55%. Conclusion: We found that orthopaedic trauma patients without a history of diabetes showed a significant independent correlation between an admission BG value of ≥200 mg/dL and 30-day surgical site infection (SSI). Because of this, admission glucose readings in orthopaedic trauma patients may be a key indicator of the risk of infection.