A A Sayampanathan1. 1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: asayampa@gmail.com.
Abstract
OBJECTIVES: We aimed to understand the effect diabetes plays on the extent of complications and patient outcomes in burn trauma. METHODOLOGY: We searched MEDLINE, Science Direct and the Cochrane Review Database for 571 articles. Through our selection criteria, 12 articles were selected for systematic review and meta-analysis. Data was analysed via Review Manager 5.3, using Mantel-Haenszel statistics and random effect models. RESULTS: The odds of a diabetic patient sustaining a wound or local infection was 2.55 times higher (95%CI: 1.21-5.36, Z=2.47; p=0.01), with a low heterogeneity (Tau2=0.00; I2=0%). Diabetics also had a higher odds of urinary tract infections (OR=3.32 (95% CI: 1.92-5.73; Z=4.31, p<0.001), low heterogeneity (Tau2=0.00; I2=0%)). In terms of length of hospital stay, the mean difference between diabetic and non-diabetic patients was 3.94 (95% CI: -2.69 to 10.6; I2=98%; p=0.24). For mortality rates, the odds ratio between diabetic and non-diabetic patients was 2.22 (95% CI: 0.45-10.9; I2=93%; p=0.32). Through our systematic review, we also found that diabetic patients are also more prone to nosocomial wound infections (OR=2.26; 95% CI=1.10-4.64), cellulitis (OR=2.69; 95% CI=1.85-3.91), bacteraemia (OR=2.91; 95% CI=1.48-5.73), sepsis (OR=4.36; 95% CI=2.20-8.64), a higher number of burn related operations (OR=3.94; 95% CI=1.94-7.90), longer period of wound closure (MD=26.8; 95% CI=8.52-45.1), respiratory complications (OR=2.91; 95% CI=1.35-6.28) and a higher number of days on ventilator (MD=8.70; 95% CI=3.51-13.89). CONCLUSIONS: Diabetic patients have a higher odds of sustaining wound infections, local infections and urinary tract infection. However, diabetic patients did not have a higher odds of longer hospital stay or mortality.
OBJECTIVES: We aimed to understand the effect diabetes plays on the extent of complications and patient outcomes in burn trauma. METHODOLOGY: We searched MEDLINE, Science Direct and the Cochrane Review Database for 571 articles. Through our selection criteria, 12 articles were selected for systematic review and meta-analysis. Data was analysed via Review Manager 5.3, using Mantel-Haenszel statistics and random effect models. RESULTS: The odds of a diabeticpatient sustaining a wound or local infection was 2.55 times higher (95%CI: 1.21-5.36, Z=2.47; p=0.01), with a low heterogeneity (Tau2=0.00; I2=0%). Diabetics also had a higher odds of urinary tract infections (OR=3.32 (95% CI: 1.92-5.73; Z=4.31, p<0.001), low heterogeneity (Tau2=0.00; I2=0%)). In terms of length of hospital stay, the mean difference between diabetic and non-diabeticpatients was 3.94 (95% CI: -2.69 to 10.6; I2=98%; p=0.24). For mortality rates, the odds ratio between diabetic and non-diabeticpatients was 2.22 (95% CI: 0.45-10.9; I2=93%; p=0.32). Through our systematic review, we also found that diabeticpatients are also more prone to nosocomial wound infections (OR=2.26; 95% CI=1.10-4.64), cellulitis (OR=2.69; 95% CI=1.85-3.91), bacteraemia (OR=2.91; 95% CI=1.48-5.73), sepsis (OR=4.36; 95% CI=2.20-8.64), a higher number of burn related operations (OR=3.94; 95% CI=1.94-7.90), longer period of wound closure (MD=26.8; 95% CI=8.52-45.1), respiratory complications (OR=2.91; 95% CI=1.35-6.28) and a higher number of days on ventilator (MD=8.70; 95% CI=3.51-13.89). CONCLUSIONS:Diabeticpatients have a higher odds of sustaining wound infections, local infections and urinary tract infection. However, diabeticpatients did not have a higher odds of longer hospital stay or mortality.
Authors: Laquanda Knowlin; Paula D Strassle; Felicia N Williams; Richard Thompson; Samuel Jones; David J Weber; David van Duin; Bruce A Cairns; Anthony Charles Journal: Burns Date: 2017-10-10 Impact factor: 2.744