Date of Award

5-10-2021

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Respiratory Therapy

First Advisor

Rachel Culbreth PhD, MPH, RRT

Second Advisor

Douglas S. Gardenhire Ed.D, RRT. RRT-NPS, FAARC

Third Advisor

Kyle Brandenburger, PhD

Abstract

Background: Diabetes Mellitus (DM) is a metabolic disease that affects the body’s ability to properly maintain accurate blood glucose levels, generally presenting as either Type I or Type II. DM has grown into a worldwide pandemic that has affected more than 422 million people, with 35 million residing in the United States. This disease is one of the most chronic health issues in the United States with over $176 billion in medical cost, due to the long-term treatment it requires and complications that may arise. Diabetics have also been found to be at a 19 percent greater risk for motor vehicle accidents (MVA) than non-diabetics, influenced by several the risk factors associated with the disease. Not only has the driving capability of the diabetic population been found to be affected, but their ability to recover is of interest as well.

Objective: The purpose of this study was to determine how DM may impact the length of stay and ventilator duration for MVA trauma patients at a Level-1 Trauma Center.

Methods: Data was collected retrospectively among patients involved in motor vehicle accidents in intensive care at a major level-1 trauma center (n=2,802). Descriptive statistics were computed and Mann-Whitney U Tests, Chi-Square tests, and Independent Samples T-Tests were conducted to examine differences in diabetic patients and demographics, comorbidities, and patient outcomes (length of stay, ventilator days, and length of ICU stay).

Results: Among all the patients (n=2802), 8.8% were confirmed to have DM, and 92.7% were non-diabetic. Although the percentage of diabetic males was greater, there was no significant difference (p=0.179) between the number of males and females effected by DM. The mean age of diabetic patients and non-diabetic was found to be significant (pp=0.380) was not significantly different, with 8.7% of diabetics in the African American population, 9.4% of Caucasians, and 6.8% of Asians. Total length of stay in the ICU (p=0.008) was significant with a median of 4 days for diabetic patients, and 3 days for non-diabetics. Total length of stay in the hospital (p=0.009) was significant as well, with a median of 10 days for diabetic patients and 7 days for non-diabetics. Total LOS on a mechanical ventilator (p=0.02) was also found to be statistically significant, with diabetic patients spending a higher number of days on the ventilator compared to non-diabetic patients.

Conclusion: MVA patients with Diabetes Mellitus may require additional interventions during their ICU and hospital stay in or to address and manage the challenges presented by the disease. The diabetic population presents with higher rates of wound infection, UTI, pneumonia, cardiac arrest, MI, ARDS, as well as unplanned intubations. Patients with DM are more likely to develop any complication following a traumatic event over patients without. Since the average age for diabetic patients is almost 60 years, people tend to develop multiple comorbidities such as obesity and other health issues. This may exacerbate their DM and make it difficult to properly maintain especially following a traumatic event such as an MVA.

DOI

https://doi.org/10.57709/22718956

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