Effect of pre-operative HbA1c and blood glucose level on the surgical site infection after lumbar instrumentation surgery

IF 1.5 4区 医学 Q3 ORTHOPEDICS
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Abstract

Background

This study aims to investigate the effect of pre-operative hemoglobin A1c (HbA1c) and pre-operative blood glucose control on the rate of surgical site infection (SSI) after posterior lumbar instrumentation surgery in diabetes mellitus (DM) patients.

Methods

A total of 1046 patients who had undergone posterior lumbar instrumentation surgery were reviewed. Based on pre-operative HbA1c, patients were divided into three groups: non-DM group, low HbA1c group (HbA1c < 7.0 % in DM) and high HbA1c group (≥7.0). As well, based on the status of blood glucose control in DM patients immediately before surgery, patients were divided into two groups: good control group (post-prandial blood glucose [PBG] < 200 mg/dl) and poor control group (≥200). The rate of SSI was compared among these groups.

Results

SSI occurred in 1.9 % in non-DM group, 2.4 % in low HbA1c group, and 9.3 % in high HbA1c group. Compared with non-DM group, high HbA1c group had significantly higher rate of SSI (p = 0.001). There was not statistically different between non-DM and low HbA1c groups (p = 0.550). SSI occurred in 2.2 % in good control group, and 10.2 % in poor control group. The rate of SSI was significantly lower in good control group (p = 0.013).

Conclusion

This study showed that the rate of SSI after posterior lumbar instrumentation surgery tend to be higher in DM patients with high HbA1c. However, the rate might be reduced to the same level as that of non-DM group by lowering PBG to <200 mg/dl immediately before surgery.

术前HbA1c和血糖水平对腰椎器械手术后手术部位感染的影响。
背景:本研究旨在探讨糖尿病(DM)患者术前血红蛋白A1c(HbA1c)和术前血糖控制对腰椎后融合术后手术部位感染率(SSI)的影响。方法:对1046例接受过腰椎后路内固定手术的患者进行回顾性分析。根据术前HbA1c将患者分为三组:非糖尿病组,低HbA1c组(HbA1c结果:非糖尿病组SSI发生率为1.9%,低HbA1c2.4%,高HbA1c 9.3%。与非糖尿病组相比,高HbAlc组SSI的发生率显著较高(p=0.001)。非糖尿病组与低HbA1c组之间无统计学差异(p=0.050)。良好对照组SSI出现率为2.2%,不良对照组为10.2%。良好对照组SSI发生率明显较低(p=0.013)。然而,通过将PBG降低到
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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