ArticleJournal of orthopaedic trauma2013
Stress-induced hyperglycemia as a risk factor for surgical-site infection in nondiabetic orthopedic trauma patients admitted to the intensive care unit.
Article in Journal of orthopaedic trauma, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Risk factors for infectious complications after open fractures; a systematic review and meta-analysis.International orthopaedics · 2017Pooled it
- [Prevention of postoperative infections : Risk factors and the current WHO guidelines in musculoskeletal surgery].Der Unfallchirurg · 2017Pooled it
- Association of Postoperative Stress Hyperglycemia Ratio with Suspected Infection, Culture Positivity, Sepsis, and Septic Shock in 1408 Patients After Cranial Neurosurgery.Journal of clinical medicine · 2026Article
- Impact of Diabetes Mellitus on Complications and Revision Risk After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2026Review
- Explainable machine learning for perioperative surgical site infection risk enrichment after operative treatment of closed pilon fractures: a multicenter retrospective study with external validation.Frontiers in surgery · 2026Article
- Perioperative Hyperglycemia is an Independent Risk Factor for Venous Thromboembolism Events After Operative Treatment of Geriatric Femur Fractures.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Exploring the Intersection of Diabetes and Musculoskeletal Health : Diabetes and Musculoskeletal Health.Galen medical journal · 2025Review
- The Interaction and Implication of Stress-Induced Hyperglycemia and Cytokine Release Following Traumatic Injury: A Structured Scoping Review.Diagnostics (Basel, Switzerland) · 2024Article
- Evaluating the Impact of Nutritional Risk on Stress-Induced Hyperglycemia and Trauma Patient Outcomes.Healthcare (Basel, Switzerland) · 2024Article
- Do preoperative glucose levels predict risk of complications in orthopaedic surgery?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Glucose-albumin ratio (GAR) as a novel biomarker of postoperative urinary tract infection in elderly hip fracture patients.Frontiers in medicine · 2024Article
- Circulating levels of micronutrients and risk of osteomyelitis: a Mendelian randomization study.Frontiers in nutrition · 2024Article
- Elevation of White Blood Cell Subtypes in Adult Trauma Patients with Stress-Induced Hyperglycemia.Diagnostics (Basel, Switzerland) · 2023Article
- The Role of the Insulin/Glucose Ratio in the Regulation of Pathogen Biofilm Formation.Biology · 2023Article
- The relationship between admission hyperglycaemia and urinary tract infections in geriatric patients with hip fractures.International orthopaedics · 2023Observational
- Neutrophil-to-lymphocyte ratio in relation to trauma severity as prognosis factors in patients with multiple injuries complicated by multiple organ dysfunction syndrome: A retrospective analysis.Immunity, inflammation and disease · 2023Article
- Morel-Lavallee lesions and number of surgeries for associated injuries predict surgical site infection risk following pelvic ring injury osteosynthesis.Scientific reports · 2023Article
- Stress-Induced Hyperglycemia is a Risk Factor for Surgical-Site Infections in Nondiabetic Patients with Open Leg Fractures.Advances in orthopedics · 2023Article
- Admission Blood Glucose Level as a Predictor of Outcome in Intensive Care Patients: A Cross-Sectional Study.Cureus · 2022Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThe aim of this study was to evaluate the association between stress-induced hyperglycemia and infectious complications in nondiabetic orthopedic trauma patients admitted to the intensive care unit (ICU).
design: This study was a retrospective review.
settingThe study was conducted at an academic level-1 trauma center. PATIENTS: One hundred and eighty-seven consecutive trauma patients with isolated orthopedic injuries were studied.
intervention: Blood glucose values during initial hospitalization were evaluated. The admission blood glucose (BG) and hyperglycemic index (HGI) were determined for each patient.
main outcome measuresPerioperative infectious complications: pneumonia, urinary tract infection (UTI), surgical-site infection (SSI), sepsis were the outcome measures.
resultsAn average of 21.5 BG values was obtained for each patient. The mean ICU and hospital length of stay was 4.0 ± 4.9 and 10.0 ± 8.1 days, respectively. Infections were recorded in 43 of 187 patients (23.0%) and SSIs specifically documented in 16 patients (8.6%). Open fractures were not associated with SSI (8/83, 9.6% vs. 8/104, 7.7%). There was no difference in admission BG or HGI and infection. However, there was a significant difference in HGI when considering SSI alone (2.1 ± 1.7 vs. 1.2 ± 1.1). Patients with an SSI received a greater amount of blood transfusions (14.9 ± 12.1 vs. 4.9 ± 7.6). No patient was diagnosed with a separate infection (ie, pneumonia, UTI, bacteremia) before SSI. There was no significant difference in injury severity score among patients with an SSI (11.1 ± 4.0 vs. 9.6 ± 3.0). Multivariable regression testing with HGI as a continuous variable demonstrated a significant relationship (odds ratio: 1.8, 95% confidence interval: 1.3-2.5) with SSI after adjusting for blood transfusions (odds ratio: 1.1, 95% confidence interval: 1.1-1.2).
conclusions: Stress-induced hyperglycemia demonstrated a significant independent association with SSIs in nondiabetic orthopedic trauma patients who were admitted to the ICU. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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