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Increased Hospital Morbidity Among Trauma Patients With Diabetes Mellitus Compared With Age- and Injury Severity Score–Matched Control Subjects
Rehan Ahmad, DO;
Robert A. Cherry, MD;
Irina Lendel, MD;
David T. Mauger, PhD;
Sara L. Service, RN, BSN, CEN;
Lindsay J. Texter, BS;
Robert A. Gabbay, MD, PhD
Arch Surg. 2007;142(7):613-618.
Hypothesis We hypothesized that patients with diabetes mellitus (DM) have worse outcomes following trauma compared with patients without a history of DM.
Design Retrospective data analysis of the Pennsylvania Trauma Systems Foundation database that compiles data from 27 accredited trauma centers in Pennsylvania.
Setting We used the Pennsylvania Trauma Systems Foundation database of 295 561 patients to compare outcomes in patients with DM vs those in patients who did not have DM.
Patients A total of 12 489 patients with DM from January 1984 to December 2002 were matched by sex, age, and Injury Severity Score with 12 489 patients who did not have DM.
Main Outcome Measures Differences in the length of hospital stay, intensive care unit stay, ventilatory assistance days, complications, and mortality rates.
Results Patients with DM spent more days in the intensive care unit and receiving ventilator support. They were more likely to have a complication (23.0% in the DM group vs 14.0% in the non-DM group [odds ratio, 1.80; 95% confidence interval, 1.69-1.92]). No difference in mortality rates or length of hospital stay was noted.
Conclusion Patients with DM exposed to trauma have greater hospital morbidity resulting from longer intensive care unit stay, increased ventilator support, and more complications.
Author Affiliations: Division of Endocrinology, Diabetes and Metabolism, Departments of Medicine (Drs Ahmad, Lendel, and Gabbay), Trauma and Critical Care (Dr Cherry and Ms Service), and Health Evaluation Sciences (Dr Mauger and Ms Texter), Penn State College of Medicine, and Milton S. Hershey Medical Center, Hershey, Pennsylvania.
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