Diabetes A Risk Factor for Catheter-Associated Infections

被引：33

作者：

Bomberg, Hagen ^{[1
]}

Kubulus, Christine ^{[1
]}

List, Franka ^{[1
]}

Albert, Noemi ^{[1
]}

Schmitt, Kathrin ^{[1
]}

Graeber, Stefan ^{[2
]}

Kessler, Paul ^{[3
]}

Steinfeldt, Thorsten ^{[4
]}

Standl, Thomas ^{[5
]}

Gottschalk, Andre ^{[6
]}

Wirtz, Stefan P. ^{[7
]}

Burgard, Gerald ^{[8
]}

Geiger, Peter ^{[9
]}

Spies, Claudia D. ^{[10
,11
]}

Volk, Thomas ^{[1
]}

机构：

[1] Univ Saarland, Univ Med Ctr, Dept Anesthesiol Intens Care Med & Pain Med, Homburg, Germany

[2] Univ Saarland, Univ Med Ctr, Inst Med Biometry Epidemiol & Med Informat, Homburg, Germany

[3] Orthoped Univ, Dept Anesthesiol Intens Care & Pain Med, Frankfurt, Germany

[4] Univ Marburg, Dept Anesthesiol & Intens Care Therapy, Marburg, Germany

[5] Acad Hosp Solingen, Dept Anesthesia Intens & Palliat Care Med, Solingen, Germany

[6] Friederikenstift Hannover, Dept Anesthesiol Intens Care & Pain Med, Hannover, Germany

[7] HELIOS Hosp, Dept Intens Care Med, Bad Saarow Pieskow, Germany

[8] HELIOS Hosp, Dept Anesthesiol Intens Care & Pain Therapy, Erfurt, Germany

[9] Univ & Rehabil Clin, Dept Anesthesioly Intens Care & Pain Therapy, Ulm, Germany

[10] Charite, ChariteCampus Virchow Klinikum, Dept Anesthesiol & Operat Intens Care Med, D-13353 Berlin, Germany

[11] Charite, D-13353 Berlin, Germany

来源：

REGIONAL ANESTHESIA AND PAIN MEDICINE | 2015年 / 40卷 / 01期

关键词：

PERIPHERAL-NERVE BLOCKS; POSTOPERATIVE ANALGESIA; PAIN MANAGEMENT; MELLITUS; SURGERY; COMPLICATIONS; PREVALENCE; ANESTHESIA; GLUCOSE; ADULTS;

D O I：

10.1097/AAP.0000000000000196

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background and Objectives: The incidence of infectious complications associated with continuous regional anesthesia techniques is a matter of concern. Our objective was to determine whether patients suffering from diabetes are at an increased risk of catheter-related infectious complications. Methods: The German Network for Regional Anaesthesia database was analyzed between 2007 and 2012. After proof of plausibility, data of 36,881 patients undergoing continuous regional anesthesia were grouped in I: no diabetes (n = 32,891) and II: any diabetes (n = 3990). The analysis focused on catheter-related infections after strict definition. Differences among the groups were tested with t and chi(2) tests. Odds ratios were calculated with logistic regression and adjusted for potential confounders. Results: Patients with a diagnosis of diabetes had an increased incidence of catheter-related infections (no diabetes 3.0% vs any diabetes 4.2%; P < 0.001). Among all patients, diabetes remained an independent risk factor for infections for all sites after the adjustment for potential confounders (odds ratio [OR] = 1.26; 95% confidence interval [95% CI], 1.02-1.55; P = 0.036). The risk of infection was significantly increased in peripheral catheters only in the lower limb (adjusted OR = 2.42; 95% CI, 1.05-5.57; P = 0.039). If neuraxial catheters were used, the risk was significantly increased only in lumbar epidural (adjusted OR = 2.09; 95% CI, 1.18-3.73; P = 0.012) for diabetic patients compared with nondiabetic patients. Conclusions: The presence of diabetes is associated with an increased risk for catheter-related infections in lower limb and lumbar epidural. Specific care should be taken to avoid and detect infections in this population.

引用

页码：16 / 21

页数：6

共 30 条

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