National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University of Malaya, Kuala Lumpur, Malaysia.
Ministry of Health, Bentong District Health Office, Bentong, Pahang, Malaysia.
J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):23094990221075376. doi: 10.1177/23094990221075376.
Upper limb infections are common among patients with diabetes mellitus and their sequelae can be debilitating. They tend to present with severe infections but minimal symptoms probably due to neuropathy and vasculopathy among diabetics. The study aims to compare the demographic characteristics, clinical presentations and outcomes of upper limb infections between diabetic and non-diabetic patients.
All patients with upper limb infections who were admitted in a tertiary hospital from June 2017 to December 2020 were included in this study. Demographic data, clinical presentations, investigations and outcomes were obtained retrospectively from electronic medical record. There were 117 patients with diabetes mellitus and 127 with no diabetes mellitus. Comparisons were made between these two groups, and statistical analysis was done with SPSS.
There were 244 patients included; 117 were diabetic and 127 were non-diabetic. Diabetic patients were more likely to present with emergent scenarios, especially necrotizing fasciitis and infective tenosynovitis ( < .05) with higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) readings ( < .05). Their microbiological cultures were less likely to be negative ( < .05). Diabetic patients also had poorer clinical outcomes with higher risk of amputation, re-operation and longer duration of hospital stay ( < .05).
Upper limb infections among diabetic patients should be treated aggressively. Early diagnosis and surgical intervention might decrease the morbidity and mortality in this group. Prevention of infections should be emphasized.
上肢感染在糖尿病患者中很常见，其后遗症可能会导致身体残疾。由于糖尿病患者存在神经病变和血管病变，他们的上肢感染可能症状轻微，但感染程度严重。本研究旨在比较糖尿病和非糖尿病患者上肢感染的人口统计学特征、临床表现和结局。
本研究纳入了 2017 年 6 月至 2020 年 12 月期间在一家三级医院住院的上肢感染患者。从电子病历中回顾性获取人口统计学数据、临床表现、检查结果和结局。共有 117 例糖尿病患者和 127 例非糖尿病患者。对这两组患者进行了比较，并使用 SPSS 进行了统计学分析。
共纳入 244 例患者，其中 117 例为糖尿病患者，127 例为非糖尿病患者。糖尿病患者更有可能出现紧急情况，尤其是坏死性筋膜炎和感染性腱鞘炎（<0.05），且红细胞沉降率（ESR）和 C 反应蛋白（CRP）读数更高（<0.05）。他们的微生物培养结果更有可能为阴性（<0.05）。糖尿病患者的临床结局也较差，截肢、再次手术和住院时间延长的风险更高（<0.05）。
应积极治疗糖尿病患者的上肢感染。早期诊断和手术干预可能会降低该人群的发病率和死亡率。应强调预防感染。
