Division of Trauma, Acute Care Surgery, and Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA.
Am Surg. 2023 Jul;89(7):3243-3245. doi: 10.1177/00031348231157888. Epub 2023 Feb 17.
Diabetes is a major determinate for mortality in trauma patients. Many diabetics are undiagnosed or poorly controlled. Trauma patients disproportionately come from lower socioeconomic status, making missed diagnoses more likely. We aimed to quantify the incidence of undiagnosed or poorly controlled diabetics assessed at a Level 1 Trauma Center. We did a retrospective chart review of admitted trauma patients over a one-month period. Past Medical History, home medication lists, and Hemoglobin A1c on admission were recorded for each patient. We determined that 30 of 173 trauma patients qualifying for the study were diabetic. Furthermore, 30% of these diabetics were undiagnosed or had poorly controlled diabetes. Undiagnosed pre-diabetics made up 20% of the entire study group. Our data show that 26% of trauma patients would benefit from an intervention for improved glucose control. Trauma centers should consider creating routine clinical practice guidelines to identify at-risk patients and provide intervention for long-term management.
糖尿病是创伤患者死亡的主要决定因素。许多糖尿病患者未被诊断或控制不佳。创伤患者不成比例地来自社会经济地位较低的人群，这使得漏诊的可能性更大。我们旨在量化在一级创伤中心评估的未确诊或控制不佳的糖尿病患者的发病率。我们对一个月内住院的创伤患者进行了回顾性图表审查。为每位患者记录了既往病史、家庭用药清单和入院时的糖化血红蛋白。我们确定，在符合研究条件的 173 名创伤患者中，有 30 名患有糖尿病。此外，这些糖尿病患者中有 30%未被诊断或糖尿病控制不佳。整个研究组中有 20%的糖尿病前期患者未被诊断。我们的数据表明，26%的创伤患者将受益于改善血糖控制的干预措施。创伤中心应考虑制定常规临床实践指南，以确定高危患者并提供长期管理的干预措施。
