糖尿病患者和多创伤患者是否继续出现更糟糕的结果?
James Tebby1, Vasileios P Giannoudis1, Sophia M Wakefield1
1Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds LS2 9LU, UK.
Journal of clinical medicine
|May 27, 2023
概括
糖尿病增加了多创伤患者的死亡风险,即使在创伤护理方面取得了进展. 这项研究强调糖尿病是严重创伤后死亡的独立风险因素.
科学领域:
- 创伤外科 手术 创伤外科
- 糖尿病学 糖尿病学
- 流行病学 流行病学
背景情况:
- 管理多创伤患者是复杂的,特别是那些患有糖尿病等并发症的人.
- 糖尿病会导致不可预测的结果,并增加创伤患者的死亡率.
研究的目的:
- 调查英国主要创伤中心对多创伤患者治疗结果的影响.
- 分析多创伤患者患有糖尿病的具体结果.
主要方法:
- 使用创伤审计和研究网络 (TARN) 数据库.
- 包括来自英格兰和威尔士的32,345名多创伤患者 (2012-2019).
- 将患者分为三组:糖尿病,其他并发症和没有并发症.
主要成果:
- 尽管总体死亡率降低,但糖尿病患者的死亡率更高.
- 增加伤害严重性评分 (ISS) 和年龄与死亡率增加相关.
- 糖尿病是死亡率的独立预测因子 (OR 1.36,p < 0.0001),即使对年龄,ISS和格拉斯哥昏迷评分进行调整.
结论:
- 多创伤患者中糖尿病的患病率正在增加.
- 糖尿病仍然是多创伤患者死亡的重要独立风险因素.
- 改善的创伤护理已经减少了跨群体的死亡率,但糖尿病继续构成更高的风险.
相关概念视频
Diabetes Mellitus: Overview and Type I Subtype
2.8K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.8K
Peripheral Artery Disease V: Postoperative Nursing Management
14
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
14
Diabetes Mellitus: Type 2 and Gestational
2.6K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.6K
Diabetes: Symptoms, Diagnosis, and Complications
606
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
606
Diabetes: Management and Pharmacotherapy
319
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
319
Carbohydrate Metabolism
11.3K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
11.3K


