부산대학교 도서관

OBJECTIVES:: To evaluate the association of admission blood glucose ≥200 mg/dL and surgical site infection in orthopaedic trauma surgery. DESIGN:: Retrospective, case control study. SETTING:: Academic trauma center. PATIENTS:: Four hundred sixty-five nondiabetic, noncritically ill orthopaedic trauma patients with an extremity, pelvic, or acetabular fracture and requiring open reduction and internal fixation or intramedullary nailing. INTERVENTION:: None. MAIN OUTCOME MEASUREMENTS:: Ninety-day deep surgical site infection. RESULTS:: Admission blood glucose ≥200 mg/dL was significantly associated with the primary outcome (8/128, 6.3% vs. 35/337, 1.8%; P = 0.01). Multivariable logistic regression modeling demonstrated that admission blood glucose ≥200 mg/dL was a significant risk factor for deep surgical site infections [odds ratio (OR): 4.7, 95% confidence interval (CI) 1.4–15.7], after controlling for male gender (OR: 1.8, 95% CI: 1.1–3.1), prior drug or alcohol abuse (OR: 1.9, 95% CI 0.9–4.0), open fracture (OR: 6.4, 95% CI 3.7–11.0), and fracture region (upper extremity OR: reference; pelvis/hip OR: 3.9, 95% CI 1.6–9.7; femur OR: 2.0, 95% CI 0.88–4.8; tibia/ankle OR: 3.3, 95% CI 1.7–6.2; and foot OR: 2.7, 95% CI 1.2–6.3). CONCLUSIONS:: Admission glucose ≥200 mg/dL was a significant independent risk factor for 90-day deep surgical site infections in orthopaedic trauma patients and may serve as an important marker for infection risk. LEVEL OF EVIDENCE:: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.