726 Pre-Operative Glycaemic Control in Diabetic Trauma Patients
C Boothman- Surgery
Abstract
Aim
To review the preoperative diabetic management of trauma patients pending theatre
Method
We analysed 2 months of trauma admissions including all patients with diabetes. We reviewed them against standards from our trust guidelines which state a blood glucose (BM), HbA1c, and urine analysis should be performed on admission. We reviewed which patients were commenced on variable rate insulin infusions (VRII) as the guidance states it should be considered when the patients’ BM is >12 or if the patient is to miss 2 or more meals.
Results
In our study population, 30% did not have a blood glucose on admission; and 80% did not have an HbA1c. Of those patients whose admission BM was over 12; 100% were started on a variable rate of insulin. The variation came with our tablet-controlled group as 33% were started on VRII and 77% were not. Of those not on VRII when it came to the day of surgery 18% had a BM of over 12. The average duration patients were kept nil by mouth was 14 hours
Conclusions
Polytrauma patients with diabetes are at higher risk of mortality; they are at increased risk of surgical site infections, poor wound healing, and non-union. This audit highlighted that the team recognise the importance of starting a VRII on those with hyperglycemia. However, going forward we need to ensure all patients have a BM on admission and this will direct our appropriate use of VRII and thus hopefully improve our trauma patients' outcomes.