title: [IMPACT OF PERIOPERATIVE AVERAGE BLOOD-GLUCOSE LEVEL ON PROGNOSIS OF PATIENTS WITH HIP FRACTURE AND DIABETES MELLITUS].
abstract: OBJECTIVE
  To explore the impact of perioperative average blood-glucose level on the prognosis of patients with hip fracture and diabetes mellitus.
  
  
  METHODS
  A retrospective analysis was made on the clinical data of 244 patients with hip fracture and diabetes mellitus who accorded with the inclusion criteria between September 2009 and September 2012. Of 244 patients, 125 patients with poorly controlled fasting blood-glucose (average fasting blood-glucose level > 7.8 mmol/L) were assigned in group A, and 119 patients with well controlled fasting blood-glucose (average fasting blood-glucose level ≤ 7.8 mmol/L) were assigned in group B according to "China guideline for type 2 diabetes" criteria. There was no significant difference in gender, age, disease duration of diabetes mellitus, serum albumin, fracture type and disease duration, surgical procedure, anaesthesia, and complications between 2 groups (P > 0.05). Group A had a higher hemoglobin level and fewer patients who can do some outdoor activities than group B (t = -2.353, P = 0.020; χ2 = 4.333, P = 0.037). The hospitalization time, days to await surgery, stitch removal time, the postoperative complication rate, the mortality at 1 month and 1 year after operation, and ambulatory ability at 1 year after operation were compared between the 2 groups.
  
  
  RESULTS
  A total of 223 patients (114 in group A and 109 in group B) were followed up 12-15 months (mean, 13.5 months). The days to await surgery of group A were significantly more than those of group B (t = -2.743, P=0.007), but no significant difference was found in hospitalization time and stitch removal time between 2 groups (P > 0.05). The postoperative complication rate of group A (19.2%, 24/125) was significantly higher than that of group B (8.4%, 10/119) (χ2 =5.926, P = 0.015). Group A had a higher mortality at 1 month after operation than group B (6.1% vs. 0) (χ2 = 5.038, P = 0.025), but no significant difference was shown at 1 year after operation between groups A and B (8.8% vs. 4.6%) (χ2 = 1.555, P = 0.212). At 1 year after operation in patients who can do some outdoor activities, the proportions of patients who turned to do some indoor activities was 19.2% (15/78) in the group A and 13.5% (12/89) in group B, showing no significant difference (χ2 = l.013, P = 0.314).
  
  
  CONCLUSIONS
  Poorly controlled perioperative fasting blood-glucose may lead undesirable influence on the prognosis of patients with hip fracture and diabetes mellitus. In order to reduce the complication rate and other accidents, the fasting blood-glucose level should be controlled to 7.8 mmol/L or less.
authors.forename: Guoqi
authors.initials: G
authors.lastname: Wang
authors.forename: Anhua
authors.initials: A
authors.lastname: Long
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Yin
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D006620:Hip Fractures / Q000097:blood; D006801:Humans; D010384:Pelvic Bones; D019990:Perioperative Care / Q000379:methods*; D059035:Perioperative Period; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose