• Hagen Bomberg, Christine Kubulus, Franka List, Noemi Albert, Kathrin Schmitt, Stefan Gräber, Paul Kessler, Thorsten Steinfeldt, Thomas Standl, André Gottschalk, Stefan P Wirtz, Gerald Burgard, Peter Geiger, Claudia D Spies, Thomas Volk, and German Network for Regional Anaesthesia Investigators.
• From the *Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, and †Institut of Medical Biometry, Epidemiology and Medical Informatics, University of Saarland, University Medical Center, Homburg/Saar; ‡Department of Anesthesiology, Intensive Care and Pain Medicine, Orthopedic University, Hospital, Frankfurt; §Department of Anesthesiology and Intensive Care Therapy, Philipps University Marburg, Marburg; ∥Department of Anesthesia, Intensive and Palliative Care Medicine, Academic Hospital Solingen, Solingen; **Department of Anesthesiology, Intensive Care and Pain Medicine, Friederikenstift Hannover, Hannover; ††Department of Intensive Care Medicine, HELIOS Hospital, Bad Saarow; ‡‡Department of Anesthesiology, Intensive Care and Pain Therapy, HELIOS Hospital, Erfurt; §§Department of Anesthesioly, Intensive Care and Pain Therapy, University and Rehabilitation Clinics, Ulm; and ∥∥Department of Anesthesiology and Operative Intensive Care Medicine, CharitéCampus Virchow Klinikum and Campus Mitte, Charité University Medicine Berlin, Germany.
• Reg Anesth Pain Med. 2015 Jan 1;40(1):16-21.

Background And ObjectivesThe incidence of infectious complications associated with continuous regional anesthesia techniques is a matter of concern. Our objective was to determine whether patients suffering from diabetes are at an increased risk of catheter-related infectious complications.MethodsThe German Network for Regional Anaesthesia database was analyzed between 2007 and 2012. After proof of plausibility, data of 36,881 patients undergoing continuous regional anesthesia were grouped in I: no diabetes (n = 32,891) and II: any diabetes (n = 3990). The analysis focused on catheter-related infections after strict definition. Differences among the groups were tested with t and χ tests. Odds ratios were calculated with logistic regression and adjusted for potential confounders.ResultsPatients with a diagnosis of diabetes had an increased incidence of catheter-related infections (no diabetes 3.0% vs any diabetes 4.2%; P < 0.001). Among all patients, diabetes remained an independent risk factor for infections for all sites after the adjustment for potential confounders (odds ratio [OR] = 1.26; 95% confidence interval [95% CI], 1.02-1.55; P = 0.036). The risk of infection was significantly increased in peripheral catheters only in the lower limb (adjusted OR = 2.42; 95% CI, 1.05-5.57; P = 0.039). If neuraxial catheters were used, the risk was significantly increased only in lumbar epidural (adjusted OR = 2.09; 95% CI, 1.18-3.73; P = 0.012) for diabetic patients compared with nondiabetic patients.ConclusionsThe presence of diabetes is associated with an increased risk for catheter-related infections in lower limb and lumbar epidural. Specific care should be taken to avoid and detect infections in this population.

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