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Open Access Highly Accessed Research article

Outcomes of polytrauma patients with diabetes mellitus

James Tebby1, Fiona Lecky2, Antoinette Edwards2, Tom Jenks2, Omar Bouamra2, Rozalia Dimitriou1 and Peter V Giannoudis134*

Author Affiliations

1 Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK

2 Trauma Audit and Research Network, 3rd Floor Mayo Building, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK

3 NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, Leeds, UK

4 LIRMM, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, Leeds, UK

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BMC Medicine 2014, 12:111  doi:10.1186/1741-7015-12-111

Published: 16 July 2014

Abstract

Background

The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus.

Methods

Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups.

Results

In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group.

Conclusions

Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity.

Keywords:
Polytrauma; Trauma; Diabetes mellitus; TARN; Trauma Audit and Research Network