The impact of diabetes on outcome in traumatically injured patients: an analysis of the National Trauma Data Bank.
BACKGROUND
Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients.


METHODS
Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome measures were mortality and infections. Age, injury severity, and comorbidities were analyzed as independent variables using logistic regression.


RESULTS
A total of 343,250 patients were analyzed, of whom 2.7% were diabetic. On multivariate analysis, insulin-dependent diabetes was an independent although weak predictor of infectious morbidity and intensive care unit length of stay. However, diabetes was not associated with mortality or hospital length of stay. Age and injury severity were the main predictors for all outcome measures.


CONCLUSIONS
Diabetes was an independent, although weak, risk factor for infectious complications in trauma patients. Age and injury severity were the most important predictors of outcome.
Kao
Lillian S
LS
Department of Surgery, University of Texas Health Science Center at Houston, 5656 Kelley St., Suite 30S 62008, Houston, TX 77026, USA. Lillian.S.Kao@uth.tmc.edu <Lillian.S.Kao@uth.tmc.edu>
Todd
S Rob
SR
Moore
Frederick A
FA
D000328:Adult; D015897:Comorbidity; D019992:Databases as Topic; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000453:epidemiology; D007239:Infections / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000401:mortality*