[The Prevalence of Hyperglycamia in Elderly Patients with Proximal Femur Fracture]

By

CHAPTER 5: CONCLUSION

Our study shows that hyperglycemia is a commonly occurring condition before and after total hip replacement surgery. It is a prevalent condition among elderly patients. According to our study, there is a strong relationship between hyperglycemia and length of hospital stay. Moreover, there is a statistically significant increase in the rate of readmission comparison on patients with proximal femoral replacement patients and planned total hip replacement.

Other preexisting medical conditions can have an effect on glucose levels in blood, but it was excluded from our study after some serious considerations. The means that patients have these effects, but it has not been clarified, although it is known that diabetes mellitus may have an effect on the functions of white blood cells and decrease the patient's immunity.

The key question that arises here is: is there a way to address this problem in a situation of trauma and surgery even planned?

These investigations have sought to control glucose levels by the use of different treatment regimens, the infusion of intravenous glucose, insulin infusion, diet control and administration of catecholamine, all of which gave different results. Our study shows that patients with normal glycemic control were much better results unless there are complications.

They also showed a lower rate of re-admission. White blood cells, especially monocytes and neutrophils, the functions are affected by hyperglycemia and decrease the body's immunity and increase the risk of infection to patients. We have also found that hyperglycemia can lead to an increase in the release of superoxide radicals and leads to endothelial dysfunction and affect pro-inflammatory cytokines that stimulate the acute phase proteins like C-reactive protein, all leading to increased inflammatory response. Hyperglycemia in elderly patients has been treated as nothing more than a phenomenon accompanying the underlying disease. However, in some cases, aggressive treatment of hyperglycemia may have a therapeutic effect, and it draws attention to the problem of correction of hyperglycemia in the setting of the hospital for patients after their THR surgeries (Ruderman et el 2000, 96-112)

The linkage that exists between acute diseases and hyperglycemia is composite. Hyperglycemia often occurs in hospitalized patients before and after their THR surgeries due to increased levels of stress hormones. Studies in experimental conditions have shown that in severe case of hyperglycemia, where in the level of glucose in the blood rises above 250 mg / dL (13.9 mmol / l), has a negative effect on the cardiovascular and immune systems. Several retrospective studies have shown that hyperglycemia is associated with death in patients who are hospitalized. The levels of Glucose after surgery is an important predictor of the likelihood of infectious complications in patients who were performed Total hip replacement surgery.

According to a study, patients suffering from diabetes mellitus experienced elevated glucose level in the blood at the time of admission. This was associated with mortality both during hospitalization and the first year after infarction.

Similar results were obtained in patients receiving treatment in intensive ...