ArticleFrontiers in surgery2026
Diabetes mellitus is an independent risk factor for surgical site infection after orthopedic Class I incision surgery: a retrospective cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Surgical site infection (SSI) is one of the most devastating complications following orthopedic Class I incision surgery. Diabetes mellitus (DM) has been implicated as an important potential risk factor, but previous studies have yielded conflicting results, largely due to the widespread use of traditional logistic regression for rare event analysis and inadequate control for confounding by surgical procedure type. This retrospective cohort study included 5,845 consecutive patients who underwent orthopedic Class I incision surgery at a tertiary hospital in Nanjing between January 2021 and December 2025. Patients were stratified into DM and non-DM groups. Stratified analysis and Firth penalized maximum likelihood logistic regression were used to control for confounding factors. Four hierarchically adjusted models were constructed to evaluate the stability of the effect of DM, and the pathogenic bacteria spectrum of SSI in our institution was characterized. The overall incidence of SSI was 0.43%. The SSI rate was significantly higher in the DM group than in the non-DM group (1.09% vs. 0.37%, relative risk (
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