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Infection Control and Hospital Epidemiology Publication Info

Article DOI: 10.1086/501830
Stable URL: http://www.jstor.org/stable/10.1086/501830
The Association of Diabetes and Glucose Control With Surgical‐Site Infections Among Cardiothoracic Surgery Patients • 
Robert Latham , MD, Ava D. Lancaster , RN, Janet F. Covington , RN, John S. Pirolo , MD and Clarence S. Thomas , Jr, MD
Infection Control and Hospital Epidemiology , Vol. 22, No. 10 (October 2001), pp. 607-612
Article DOI: 10.1086/501830
Article Stable URL: http://www.jstor.org/stable/10.1086/501830
Original Articles

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

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Abstract(back to top)

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 A1c 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 A1c values were not associated with a statistically significantly increased risk of infection; the mean A1c 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 [7%] vs 17/300 [6%]; P=.72). An additional 30% of nondiabetics had elevated hemoglobin A1c 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.

Bibliographic Information(back to top)

  • The Association of Diabetes and Glucose Control With Surgical‐Site Infections Among Cardiothoracic Surgery Patients
  • Robert Latham , MD, Ava D. Lancaster , RN, Janet F. Covington , RN, John S. Pirolo , MD and Clarence S. Thomas , Jr, MD
  • Infection Control and Hospital Epidemiology
  • Vol. 22, No. 10 (October 2001) (pp. 607-612)

Author Information(back to top)

Robert Latham , MD; Ava D. Lancaster , RN; Janet F. Covington , RN; John S. Pirolo , MD; Clarence S. Thomas , Jr, MD

Notes and References(back to top)

This item contains 1 note(s).

Notes

From the Department of Medicine, Vanderbilt University (Dr. Latham); Hospital Epidemiology, Saint Thomas Hospital (Dr. Latham, Ms. Lancaster, and Ms. Covington); and Cardiovascular Surgical Associates, Saint Thomas Heart Institute, Saint Thomas Hospital (Drs. Pirolo and Thomas), Nashville, Tennessee.Address reprint requests to Robert Latham, MD, PO Box 380, Saint Thomas Hospital, Nashville, TN 37202.This study was supported by a grant from the Saint Thomas Foundation.The authors thank the members of the Cardiovascular Surgery Associates: Stephen K. Ball, MD; George R. Burrus, MD; William H. Coltharp, MD; David M. Glassford, Jr, MD; Steven J. Hoff, MD; John W. Lea, IV, MD; Jonathan C. Nesbitt, MD; Michael R. Petracek, MD; Todd A. Shuman, MD; Thomas D. Starkey, MD; Mark Tedder, MD, who enrolled the patients; Members of the Saint Thomas Heart Institute: Judy McCarthy, RN; Pat McGaw, RN, who enrolled patients and collected data; and Saint Thomas Hospital Laboratory Personnel: Gina Young, MT(ASCP), who provided technical support.01‐OA‐033. Latham R, Lancaster AD, Covington JF, Pirolo JS, Thomas CS Jr. The association of diabetes and glucose control with surgical‐site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 2001;22:607‐612.

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© 2001 by The Society for Healthcare Epidemiology of America. All rights reserved.