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

Published online by Cambridge University Press:  02 January 2015

Robert Latham ,
Ava D. Lancaster ,
Janet F. Covington ,
John S. Pirolo  and
Clarence S. Thomas Jr
Robert Latham*
Affiliation:
Department of Medicine, Vanderbilt University, Nashville, Tennessee Hospital Epidemiology, Saint Thomas Hospital, Nashville, Tennessee
Ava D. Lancaster
Affiliation:
Hospital Epidemiology, Saint Thomas Hospital, Nashville, Tennessee
Janet F. Covington
Affiliation:
Hospital Epidemiology, Saint Thomas Hospital, Nashville, Tennessee
John S. Pirolo
Affiliation:
Cardiovascular Surgical Associates, Saint Thomas Heart Institute, Saint Thomas Hospital, Nashville, Tennessee
Clarence S. Thomas Jr
Affiliation:
Cardiovascular Surgical Associates, Saint Thomas Heart Institute, Saint Thomas Hospital, Nashville, Tennessee
*
PO Box 380, Saint Thomas Hospital, Nashville, TN 37202
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Abstract

Objective:

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.

Setting:

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

Design:

Prospective cohort and case-control studies.

Patients:

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.

Results:

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.

Conclusions:

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 10 , October 2001 , pp. 607 - 612
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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