{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:29:25Z","timestamp":1787164165400,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T00:00:00Z","timestamp":1698192000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Advances in Orthopedics"],"published-print":{"date-parts":[[2023,10,25]]},"abstract":"<jats:p>\n                    Background. Nondiabetic patients with open leg fractures who have elevated blood glucose levels on arrival in the emergency department have an increased risk of surgical-site infections (SSIs). Objective. This study evaluates the association between the incidence of SSIs in nondiabetic patients with an open leg fracture and blood glucose levels registered on arrival in the ER. We also analyzed the correlation between patients\u2019 days of hospital stay and the incidence of SSIs and the time elapsed between the damage control with external fixation and final fixation and the incidence of SSI. Methods. We retrospectively studied nondiabetic patients admitted to our emergency unit from 2017 to 2021 with a diagnosis of open leg fracture consecutively treated. Based on the diagnosis of SSIs, all enrolled patients were divided into two groups based on the developed (group A) or not developed (group B) SSIs within 1\u2009year after surgery. All patients enrolled in the study underwent damage control within 24\u2009hours after admission to the ER. At stabilization of general clinical and local wound conditions, all patients underwent definitive surgery. Results. We enrolled 80 patients. In group A, glycemia on arrival in the ER was on average 148.35\u2009\u00b1\u200919.59\u2009mg\/dl, and in group B, it was 122.61\u2009\u00b1\u200922.22\u2009mg\/dl (\n                    <jats:inline-formula>\n                      <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                      <\/a:math>\n                    <\/jats:inline-formula>\n                    value: 0.0001). In group A, glycemia in the first postoperative day was on average 113.81\u2009\u00b1\u200921.07\u2009mg\/dl, and in group B, it was 99.02\u2009\u00b1\u200917.60\u2009mg\/dl (\n                    <jats:inline-formula>\n                      <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                      <\/c:math>\n                    <\/jats:inline-formula>\n                    value: 0.001). In group A, the average hospitalization was 57.92\u2009\u00b1\u200942.43\u2009days, and in group B, it was 18.41\u2009\u00b1\u200914.21 days (\n                    <jats:inline-formula>\n                      <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                      <\/e:math>\n                    <\/jats:inline-formula>\n                    value: 0.01). Through Youden\u2019s J, we therefore analyzed the value with the highest sensitivity and specificity which proved to be 132\u2009mg\/dl. Conclusion. Our findings show that nondiabetic patients with SIH have a significantly increased risk of SSIs compared to patients without SIH within 1\u2009year after surgery. Patients with open leg fractures with SIH have a significantly higher average hospital stay than patients without SIH. Further studies are needed to confirm 132\u2009mg\/dl of blood glucose levels as a value to stratify the risk of SSIs in these patients.\n                  <\/jats:p>","DOI":"10.1155\/2023\/6695648","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T16:35:06Z","timestamp":1698251706000},"page":"1-8","source":"Crossref","is-referenced-by-count":8,"title":["Stress-Induced Hyperglycemia is a Risk Factor for Surgical-Site Infections in Nondiabetic Patients with Open Leg Fractures"],"prefix":"10.1155","volume":"2023","author":[{"given":"Luigi","family":"Cianni","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Caredda","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8321-532X","authenticated-orcid":true,"given":"Andrea","family":"De Fazio","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Basilico","sequence":"additional","affiliation":[{"name":"Aurelia Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Greco","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpiero","family":"Cazzato","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. 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