Diabetes in Trauma Patients: A Potential Gateway to a Medical Home.

Autor:	Hart K; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Thames MA; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Massey AC; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Capasso T; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Lee YL; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Mbaka M; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Kinnard CM; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Bright AC; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Williams AY; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Polite NM; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Simmons JD; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA., Butts CC; Division of Trauma, Acute Care Surgery, & Burns, Department of Surgery, University Hospital, University of South Alabama Frederick P. Whiddon College of Medicine, Mobile, AL, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Jul; Vol. 90 (7), pp. 1849-1852. Date of Electronic Publication: 2024 Mar 22.
DOI:	10.1177/00031348241241615
Abstrakt:	Background: Diabetes is a major determinant of health outcomes. Trauma patients are disproportionately from lower socioeconomic status, where lack of access to health care prevents timely treatment. Trauma centers could play a role in identifying patients in need of improved glucose management, but the current burden of disease is not known. We assessed the incidence of patients in need of intervention that presented to a level 1 trauma center over a 6-month period. Methods: A retrospective chart review over 6 months of all trauma patients admitted to a level 1 trauma center was performed. Patients' past medical history (PMH), medication reconciliation, and hemoglobin A1c (HbA1c) were recorded on initial assessment; patients <18 years old, lacking an HbA1c, or missing PMH were excluded. Patients with PMH of diabetes or antihyperglycemic use were classified by HbA1c: well-controlled ≤8.0% or poorly controlled >8.0%. Patients with no history of diabetes or antihyperglycemic use were classified based on their HbA1c: non-diabetic <5.7%, pre-diabetic 5.7-6.4%, and undiagnosed diabetic ≥6.5%. Results: Overall, 1377 patients were identified. After exclusion criteria, 903 patients were classified as follows: 593 (66%) non-diabetics, 160 (18%) pre-diabetics, and 150 (17%) diabetics. Fifteen diabetics were undiagnosed; 39 of the diagnosed diabetics were poorly controlled. Including pre-diabetics, a total of 214 (24%) trauma patients were in need of improved glycemic control. Discussion: One in four trauma patients would benefit from improved outpatient glycemic management, representing a missed opportunity for preventative health care. Trauma centers should develop strategies to meet this need as part of their post-discharge care. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu