Morbidity and mortality of Hispanic trauma patients with diabetes mellitus

Abstract

Purpose DM and trauma are leading causes of death in Hispanic patients, yet the interaction between them remains obscure. We aimed to assess the complications and in-hospital mortality rate of Hispanic diabetic trauma patients. Methods A retrospective cohort study was carried out using data from the Puerto Rico Trauma Hospital databank. Patients were matched based on gender, age, mechanism of injury, Glasgow Coma Scale, and Injury Severity Score using propensityscore matching. From 2000 to 2014, a total of 1134 patients with DM were compared to 1134 patients who did not have DM. The outcomes measured were hospital and TICU lengths of stay, days on mechanical ventilation, complications, and in-hospital mortality rate. A logistic regression model was carried out to evaluate the relationship of DM with complications and mortality after trauma. Results Hispanic patients with DM had longer hospital and TICU stays and required mechanical ventilation for extended periods. Complications, predominantly of an infectious nature, were more common among DM patients than they were among non-DM patients: 31.3% in the DM group vs. 11.6% in the non-DM group (OR 3.46; 95% CI 2.77-4.31). Despite an increase in the number of complications, DM was not associated with higher in-hospital mortality rates. Conclusions DM is associated with a twofold increase in complications in Hispanic diabetic trauma patients, which may account for their longer hospital and TICU stays. This indicates that diabetic Hispanic trauma patients may need earlier and more aggressive intervention to reduce their risk of developing complications.

Maternal Outcomes After Trauma in Pregnancy: A National Database Study

“…Over, 94.5% of the cohort had blunt injuries and 3.8% had penetrating injuries. Median (IQR) GCS and ISS were 15 (15,15) and 2 (1,5), respectively. 51.5% of the patients were admitted to the floor and 9.3% went to the operating room (OR) from the emergency department (ED).…”

“…Trauma can also cause stress-induced hyperglycemia, which has been linked to an increased risk of infectious complications and mortality. 15 Gestational diabetes, in combination with stress-induced hyperglycemia puts this population at greater risk, prompting trauma providers to screening for diabetes and hyperglycemia in pregnant women of any age group to avoid negative outcomes for both mother and fetus. According to Corrina et al, there are several major risk factors for maternal trauma.…”

Obesity Effect on the Course of Abdominal Trauma

“…However, these scales do not take into account individual characteristics of the victim, which affect both the initial response to the trauma and subsequent compensatory and restorative processes. The risk factors for adverse course of traumas often include concomitant pathology [3,4]. Overweight and obesity, prevalence of which is increasing worldwide, is noteworthy among the concomitant pathology [5].…”

Association of serum osteocalcin levels with glucose metabolism in trauma patients

“…[ 3 ] Diabetic trauma patients are prone to developing infectious complications. [ 4 ] The mechanism of abnormal glucose metabolism induced by trauma is complex, and the pathophysiological mechanism is currently not well understood.…”