ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2020
Stress Hyperglycemia and Complications Following Traumatic Injuries in Individuals With/Without Diabetes: The Case of Orthopedic Surgery.
Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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21 citing papers in PubMed, 43 citations in OpenAlex.
- Length of stay after lumbar decompressive surgery: prediction model, clinical reasons for prolonged stay, and association of prolonged stay with outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Obesity significantly elevates thromboembolism risk in severe trauma, yet essential resuscitation with TXA and erythrocytes remains safe.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Performance and accuracy of blood glucose and neutrophil-lymphocyte ratio as predictors of mortality in children and adolescents with traumatic brain injury.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Association of preoperative fasting blood glucose with 1-year Harris Hip Score after hip fracture in older adults: a multicenter retrospective cohort study.Frontiers in endocrinology · 2026Observational
- Elevated stress hyperglycemia ratio predicts intensive care unit admission after surgery for gastrointestinal tumors: an INSPIRE database analysis.Frontiers in medicine · 2026Article
- Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling-A Prospective Study Across Multiple Surgical Specialties.Medical sciences (Basel, Switzerland) · 2025Article
- Admission Blood Glucose Level with a Cutoff Value of 15 mmol/L Is a Reliable Predictor of Mortality in Polytraumatized Patients-a Prospective, Observational, Longitudinal Study From a North African Level One Trauma Center.Orthopedic research and reviews · 2025Article
- Article
- Do preoperative glucose levels predict risk of complications in orthopaedic surgery?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- The Glycemic Ratio Is Strongly and Independently Associated With Mortality in the Critically Ill.Journal of diabetes science and technology · 2024Article
- Elevation of White Blood Cell Subtypes in Adult Trauma Patients with Stress-Induced Hyperglycemia.Diagnostics (Basel, Switzerland) · 2023Article
- The impact of Charlson Comorbidity Index on surgical complications and reoperations following simultaneous bilateral total knee arthroplasty.Scientific reports · 2023Article
- Strategies for intraoperative glucose management: a scoping review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Absolute Hyperglycemia versus Stress Hyperglycemia Ratio for the Prognosis of Hospitalized Patients with COVID-19 in the First Months of the Pandemic: A Retrospective Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- Stress Hyperglycemia Ratio as a Prognostic Marker in Diabetic Patients Hospitalized with COVID-19.Infectious disease reports · 2022Article
- The stress hyperglycemia ratio, a novel index of relative hyperglycemia, predicts short-term mortality in critically ill patients after esophagectomy.Journal of gastrointestinal oncology · 2022Article
- Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection.Frontiers in medicine · 2022Article
- Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients.Journal of clinical medicine · 2021Article
- Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care.Scientific reports · 2021Article
- Stress Hyperglycemia and Mortality in Subjects With Diabetes and Sepsis.Critical care explorations · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHyperglycemia in trauma patients may stem from metabolic response to stress, both in the presence and the absence of underlying diabetes. We aimed to test the association of stress hyperglycemia with risks of adverse events subjects undergoing orthopedic surgery. PATIENTS AND
methodsIn a prospective observational study, we enrolled 202 consecutive patients with hyperglycemia at hospital admission for trauma injuries requiring orthopedic surgery. Based on history, diabetes was present in 183, and 13 more were defined as unknown diabetes on the basis of HbA1c ≥48mmol/mol. Stress hyperglycemia was defined in subjects with/without diabetes by a stress hyperglycemia ratio (SHR) >1.14, calculated as admission glucose/average glucose, estimated from glycosylated hemoglobin. Logistic regression analysis was used to calculate the risk of post-surgery adverse events associated with different states of hyperglycemia, after correction for demographic and clinical confounders.
resultsStress hyperglycemia was diagnosed, either as superimposed to diabetes (54/196 cases, 27.6%) as well as in the 6 cases without diabetes. At least one complication was recorded in 68 cases (33.7%), the most common being systemic infection (22.8% of cases). In the total cohort, stress hyperglycemia, irrespective of the presence of diabetes, increased the risk of adverse events (any events, odds ratio [OR], 4.43; 95% confidence interval [CI], 2.11-9.30), cardiovascular events (OR, 7.09; 95% CI, 2.47-19.91), systemic infections (OR, 4.21; 95% CI, 1.97-9.03) and other adverse events (OR, 6.30; 95% CI, 1.41-28.03), after adjustment for confounders; hospital stay was much longer. The same was true when the analysis was limited to the diabetes cohort or by comparing pure stress hyperglycemia vs diabetes without stress hyperglycemia.
conclusionThe study highlights the importance of stress hyperglycemia for adverse events in the setting of orthopedic surgery following trauma injuries. This condition requires stricter management, considering the much longer length of hospital stay and higher costs.
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