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The Association of Diabetes and Glucose Control With Surgical-Site Infections Among Cardiothoracic Surgery Patients

  • Robert Latham (a1) (a2), Ava D. Lancaster (a2), Janet F. Covington (a2), John S. Pirolo (a3) and Clarence S. Thomas (a3)...
Abstract
Abstract <span class='bold'>Objective:</span>

To assess the importance of diabetes, diabetes control, hyperglycemia, and previously undiagnosed diabetes in the development of surgical-site infections (SSIs) among cardiothoracic surgery patients.

<span class='bold'>Setting:</span>

A 540-bed tertiary-care university-affiliated hospital.

<span class='bold'>Design:</span>

Prospective cohort and case-control studies.

<span class='bold'>Patients:</span>

All patients having cardiothoracic surgery between November 1998 and September 1999 were eligible for participation. One thousand patients had preoperative hemoglobin Ale determinations. Seventy-four patients with SSIs were identified.

<span class='bold'>Results:</span>

Diabetes (odd ratio [OR], 2.76; P<.001) and postoperative hyperglycemia (OR, 2.02; P=.007) were independently associated with development of SSIs. Among known diabetics, elevated hemoglobin Ale values were not associated with a statistically significantly increased risk of infection; the mean Ale value was 8.44% among those with infections compared with 7.80% for those without (P=.09). Forty-two (6%) of 700 patients without prior diabetes history had evidence of undiagnosed diabetes; their infection rate was comparable to that of known diabetics (3/42 [796] vs 17/300 [6%]; P=.72). An additional 30% of nondiabetics had elevated hemoglobin Ale determinations or perioperative hyperglycemia.

<span class='bold'>Conclusions:</span>

Postoperative hyperglycemia and previously undiagnosed diabetes are associated with development of SSIs among cardiothoracic surgery patients. Screening for diabetes and hyperglycemia among patients having cardiothoracic surgery may be warranted to prevent postoperative and chronic complications of this metabolic abnormality.

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Corresponding author
PO Box 380, Saint Thomas Hospital, Nashville, TN 37202
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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