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Hyperglycemia as a risk factor for postoperative early wound infection after bicondylar tibial plateau fractures: Determining a predictive model based on four methods

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dc.creatorRodriguez-Buitrago A.spa
dc.creatorBasem A.spa
dc.creatorOkwumabua E.spa
dc.creatorEnata N.spa
dc.creatorEvans A.spa
dc.creatorPennings J.spa
dc.creatorKaracay B.spa
dc.creatorRice M.J.spa
dc.creatorObremskey W.spa
dc.date.accessioned2020-05-26T00:11:36Z
dc.date.available2020-05-26T00:11:36Z
dc.date.created2019spa
dc.description.abstractObjectives: Identify a glucose threshold that would put patients with isolated bicondylar tibial plateau fractures at risk of early wound infection (i.e. less than 90 days). Design: Retrospective review of medical records. Setting: Academic American College of Surgeons (ACS) Level 1 trauma center. Patients: Adult patients between 2010 and 2015 with an operatively treated isolated bicondylar tibial plateau fracture and at least three glucose measurements during their hospitalization. Main Outcome Measurement: To predict infection using four different methods: maximum preoperative blood glucose (PBG), maximum blood glucose (MGB), Hyperglycemic Index (HGI), and Time-Weighted Average Glucose (TWAG). Results: 126/381 patients met our inclusion criteria. Fifteen (12%) patients had an open fracture and 30/126 (23%) developed an infection. Median glucose for each predictive method studied was 114 (IQR 101.2–137.8) mg/dL for PBG, 144 (IQR 119–169.8) mg/dL for MBG, 0.8 (IQR 0.20–1.60) mmol/L for HGI, and 120.4 (IQR 106.0–135.6) mg/dL for TWAG. As expected, infected patients had higher PBG, MGB, and TWAG. HGI was similar in both groups. None of these differences prove to be statistically significant (p > .05). Logistic regression models for all the methods showed that having an open fracture was the strongest predictor of infection. Conclusion: It is well known that stress-induced hyperglycemia increases the risk of infection, we present and compare four models that have been used in other medical fields. In our study, none of the methods presented identified a glucose threshold that would increase the risk of infection in patients with bicondylar tibial plateau fractures. Level of Evidence: Retrospective review, Level III. See Instructions for Authors for a complete description of levels of evidence. © 2019 Elsevier Ltdeng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.injury.2019.07.028
dc.identifier.issn00201383
dc.identifier.issn15723461
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24314
dc.language.isoengspa
dc.publisherElsevier Ltdspa
dc.relation.citationEndPage2102
dc.relation.citationIssueNo. 11
dc.relation.citationStartPage2097
dc.relation.citationTitleInjury
dc.relation.citationVolumeVol. 50
dc.relation.ispartofInjury, ISSN:00201383, 15723461, Vol.50, No.11 (2019); pp. 2097-2102spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85069657121&doi=10.1016%2fj.injury.2019.07.028&partnerID=40&md5=6ac376ecbab1b7a4679721f1101a7a73spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordCefazolinspa
dc.subject.keywordGlucosespa
dc.subject.keywordAdultspa
dc.subject.keywordAgedspa
dc.subject.keywordArticlespa
dc.subject.keywordBicondylar tibial plateau fracturespa
dc.subject.keywordControlled studyspa
dc.subject.keywordDisease assessmentspa
dc.subject.keywordFemalespa
dc.subject.keywordGlucose blood levelspa
dc.subject.keywordHospitalizationspa
dc.subject.keywordHumanspa
dc.subject.keywordHyperglycemiaspa
dc.subject.keywordHyperglycemic indexspa
dc.subject.keywordInjury scalespa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordOpen fracturespa
dc.subject.keywordPreoperative periodspa
dc.subject.keywordPriority journalspa
dc.subject.keywordRetrospective studyspa
dc.subject.keywordSurgical infectionspa
dc.subject.keywordTibial plateau fracturespa
dc.subject.keywordWound infectionspa
dc.subject.keywordHyperglycemiaspa
dc.subject.keywordInfectionspa
dc.subject.keywordOrthopaedic traumaspa
dc.subject.keywordSurgical site infectionspa
dc.subject.keywordTibial plateau fracturesspa
dc.titleHyperglycemia as a risk factor for postoperative early wound infection after bicondylar tibial plateau fractures: Determining a predictive model based on four methodsspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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