Risk Factors for Hand Wound Infections in People with Diabetes: A Case-control Study

Estrella, Emmanuel P.; Lee, Ellen Y.

doi:10.25270/wmp.2019.8.3843

Cited by 9 publications

(6 citation statements)

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“…The main causes included three categories: 1) trauma; 2) unknown causes or no history of injuries; and 3) postoperative or iatrogenic causes. 33 – 41 …”

Section: Resultsmentioning

confidence: 99%

“…The main causes included three categories: 1) trauma; 2) unknown causes or no history of injuries; and 3) postoperative or iatrogenic causes. [33][34][35][36][37][38][39][40][41] 3.2.2. According to the analysis of results reported in the literature (Table 1, Figure 2), both mixed bacteria (31.2% vs. 16.6%, p=0.014) and fungi (7.5% vs. 0.8%, p=0.017) in nontropical regions were signi cantly higher than those in tropical regions.…”

Section: 2mentioning

confidence: 99%

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Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions

Chen,

Liu,

Huan

et al. 2024

Preprint

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Purpose: Hand infection is a rare complication in patients with diabetes. Its clinical outcomes depend on the severity of hand infection caused by bacteria, but the difference in bacterial species in the regional disparity is unknown. The purpose of this study was to explore the influence of tropical and nontropical regions on bacterial species and clinical outcomes for diabetic hand. Patients and Methods: A systematic literature review was conducted using PubMed, EMBASE, Web of Science, and Google Scholar. Moreover, the bacterial species and clinical outcomes were analyzed with respect to multicenter wound care in China (nontropical regions). Results: Both mixed bacteria (31.2% vs. 16.6%, p=0.014) and fungi (7.5% vs. 0.8%, p=0.017) in the nontropical region were significantly more prevalent than those in the tropical region. Staphylococcus and Streptococcus spp. were dominant in gram-positive bacteria, and Klebsiella, Escherichia coli, Proteus and Pseudomonas in gram-negative bacteria occupied the next majority in the two regions. The rate of surgical treatment in the patients was 31.2% in the nontropical region, which was significantly higher than the 11.4% in the tropical region (p=0.001). Although the overall mortality was not significantly different, there was a tendency to be increased in tropical regions (6.3%) compared with nontropical regions (0.9%). However, amputation (32.9% vs. 31.3%, p=0.762) and disability (6.3% vs. 12.2%, p=0.138) were not significantly differentbetween the two regions. Conclusion: Similar numbers of cases were reported, and the most common bacteria were similar in tropical and nontropical regions in patients with diabetic hand. There were more species of bacteria in the nontropical region, and their distribution was basically similar, except for fungi, which had differences between the two regions. The present study also showed that surgical treatment and mortality were inversely correlated because delays in debridement and surgery can deteriorate deep infections, eventually leading to amputation and even death.

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“…The main causes included three categories: 1) trauma; 2) unknown causes or no history of injuries; and 3) postoperative or iatrogenic causes. 33 – 41 …”

Section: Resultsmentioning

confidence: 99%

Section: 2mentioning

confidence: 99%

Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions

Chen,

Liu,

Huan

et al. 2024

Preprint

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“… 17 , 18 The study of Baltrusaitis about hand trauma suggests that the wounds were more susceptible to infection in patients with high HbA1c. 19 The result of Iavazzo study suggests that the increase of preoperative HbA1c may indicate a higher risk of infection complications and readmission within 30 days in both diabetic and non-diabetic patients. 20 …”

Section: Discussionmentioning

confidence: 98%

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Guo¹,

Shen²

2021

IDR

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Background and Purpose Infection is a common comorbidity and cause of death in emergency trauma patients, especially in diabetic patients. Once the patients are admitted, they are more susceptible to further complications like sepsis and resultant increase in in-hospital mortality. Therefore, it is necessary to evaluate risk factors associated with sepsis after trauma and death in trauma patients. Methods A total of 397 trauma patients were divided into 2 groups according to HbA1c level, HbA1c: <6.5% (n = 259), HbA1c: >6.5% (n = 138), and baseline clinical characteristics were collected. The independent risk factors of sepsis associated with trauma were screened using univariate and multivariate logistic regression analysis. Cox proportional hazards regression analysis was used to investigate risk factors for 30-day all-cause mortality. Results The sepsis incidence (76.1% vs 35.9%, P<0.001) and mortality rate (29.7% vs 7.3%, P<0.001) were significantly higher in HbA1c>6.5% group. Multivariate logistic regression analysis revealed that the independent risk factors of sepsis after trauma were diabetes (OR: 3.1, 95% CI: 1.41–6.79), hypertension (OR: 2.55, 95% CI: 1.35–4.82), coagulation disorder (OR: 3.45, 95% CI: 1.23–9.67), creatinine (OR: 3.71, 95% CI: 1.66–8.31), urea nitrogen (OR: 0.96, 95% CI: 0.92–0.99), HbA1c%>6.5 (OR: 2.05, 95% CI: 1.65–2.54), increase in body mass index (OR: 1.08, 95% CI: 1.03–1.13) and lower initial GCS score (OR: 0.93, 95% CI: 0.88–0.99). Multivariable Cox proportional hazard analysis revealed that male (HR: 1.94, 95% CI: 1.21–3.12), HbA1c >6.5% (HR: 1.45, 95% CI: 1.32–1.6), albumin (HR: 0.54, 95% CI: 0.34–0.86), creatinine (HR: 1.02, 95% CI: 1.01–1.03), APTT (HR: 1.02, 95% CI: 1.01–1.03), SOFA score (HR: 1.2, 95% CI: 1.1–1.31), age >65 years (HR: 3.21, 95% CI: 1.95–5.3) were independent risk factor for trauma patients’ mortality. Conclusion The prevalence of sepsis and mortality was higher in trauma patients with HbA1c >6.5%. HbA1c was independent risk factor for sepsis and all cases of mortality in trauma patients.

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“…Elevated HbA1c levels in patients with type 2 diabetes are reportedly associated with increased risk of early postoperative infections, and the risk of sternal infection is ve-fold higher (OR = 5.3) when the HbA1c level is > 7.8% [28]. In terms of the effect on the immune system, poor long-term blood sugar control affects the function of monocytes and neutrophils, including adhesion, chemotaxis, phagocytosis, and other important processes; it also detrimentally affects β-cell reserves and insulin receptors, resulting in an infection-prone immunocompromised state [29]. Type 2 diabetes can cause microvascular lesions, leading to delayed wound healing, increased risk of postoperative site infection, insu cient nutrition, and inadequate local blood supply in the surgical area [30].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Risk Factors for Infection after Percutaneous Vertebroplasty Augmentation for Osteoporotic Vertebral Compression Fracture

Chen,

Chen

et al. 2024

Preprint

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Background: Percutaneous vertebral augmentation (PVA) is a widely implemented treatment of osteoporotic vertebral compression fracture (OVCF). Although rare, surgical site infection (SSI) is a serious complication of PVA. Even though it is of great medical significance to minimize SSIs after PVA, there have been few reports on systematic risk factor analysis and prevention strategies.The goal of this study was to analyze the incidence and risk factors of postoperative SSI in PVA at a single center and formulate prevention strategies. Methods: The study involved 2624 patients who underwent PVA for osteoporotic vertebral compression fracture (OVCF) at our hospital between 2015 and 2021. The case-control study method was utilized. The case group consisted of patients who developed postoperative infections, while the control group was composed of uninfected patients selected at a ratio of 1:3.We collected data on risk factors for SSIs from patients' electronic medical records, imaging findings, and laboratory test results. We then analyzed the independent risk factors for postoperative SSIs using Cox univariate and multivariate regression analyses. Results: In our study, 17/2624 patients (0.65%) developed postoperative vertebral infections.Use of steroid drugs, NEUT%, C-type bone cement leakage after the operation were identified as risk factors in univariate analysis but not in multivariate analysis. Finally, multivariate analysis revealed the following risk factors for infectious spondylitis: age ≥ 80 years, type 2 diabetes, pulmonary infection, Alb ≤ 35 g/L, preoperative MRI indicating signs of fluid accumulation in the fractured vertebral body, and D-type bone cement leakage after the operation. Conclusions: Multivariate analyses identified the abovementioned independent risk factors for postoperative SSIs after PVA. These data may help guide clinicians take preoperative preventive measures to reduce the incidence of postoperative SSIs after PVA. Trial registration: This study was approved by Guangdong Province Hospital of Traditional Chinese Medicine. This article is a retrospective study. Therefore, the institution waived the requirement to obtain distinct written informed consent from the patients (approval number: ZE2023-176-01).

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Risk Factors for Hand Wound Infections in People with Diabetes: A Case-control Study

Cited by 9 publications

References 0 publications

Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions

Comparison of bacterial species and clinical outcomes in patients with diabetic hand infection in tropical and nontropical regions

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Risk Factors for Infection after Percutaneous Vertebroplasty Augmentation for Osteoporotic Vertebral Compression Fracture

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