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Diabetes Identified as Risk Factor for Surgical Site Infections

Patients with diabetes are at considerably increased risk for developing surgical site infections (SSIs), compared to patients without diabetes, according to a new study published online in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

“Diabetes has been recognized as a risk factor for infection following some surgeries, but has been a source of debate for other procedures,” said Emily Toth Martin, PhD, lead author of the study and assistant professor of epidemiology at the University of Michigan School of Public Health. “This study is a first step in our efforts to identify patients at high risk of SSIs. We hope this research will lead to better strategies to lower the number of these infections nationwide.”

The researchers conducted a systematic review and meta-analysis spanning 94 studies published between 1985 and 2015, and analyzed data based on estimates of diabetes, SSIs, types of procedures, blood glucose levels, and body mass index.

They found that patients with diabetes undergoing surgery were 50 percent more likely to develop an SSI compared to patients without diabetes.

SSIs were the most frequent cause of hospital-acquired infection, occurring in 4 percent of surgeries in this study. These infections are estimated to have an annual financial impact of more than $3 billion nationally and are the largest contributor to the overall costs of healthcare-associated infections. Efforts to reduce the rates of SSIs are becoming more urgent since the introduction of penalties for hospital readmissions by the Centers for Medicare & Medicaid Services.

Previous studies had found increased risk for patients with diabetes during several types of surgery, but the new research confirmed that a broader range of procedures had elevated risk of SSIs, including arthroplasty, breast, cardiac, and spinal surgeries.

“Hospitals routinely monitor glucose levels in surgical patients, but heightened awareness among healthcare professionals of infection prevention measures is warranted for diabetic patients before and after surgery,” said Martin.

This article was adapted from information provided by SHEA.