Department of Burn Plastic Surgery, The Fourth People's Hospital of Jinan, Jinan, Shandong Province, P.R. China.
Eur Rev Med Pharmacol Sci. 2021 Mar;25(6):2481-2492. doi: 10.26355/eurrev_202103_25411.
Burns are one of the most commonly occurring soft tissue injuries worldwide. It has been reported that burns are associated with a higher prevalence of complications, mortality, and hospitalization-related outcomes in patients with coexisting diabetes mellitus. Moreover, the morbidity and mortality related outcomes associated with diabetes in patients with burns. However, since then, several studies reporting the prognostic role of diabetes in patients with burns have been published. Therefore, in this present study, we attempt to develop a current state of evidence evaluating the prognostic influence of diabetes mellitus on infectious complications, duration of hospital stay and mortality-related outcomes in patients with burns. The aim of the study is to determine the overall effect of diabetes mellitus on infectious complications, duration of hospital stay and mortality-related outcomes in patients with burns.
We performed a systematic search of the academic literature in four academic databases including EMBASE, CENTRAL, Scopus, and MEDLINE according to PRISMA guidelines. A random effect meta-analysis was carried out to evaluate the pooled effect size associated with diabetes mellitus on the outcome of infectious complications, duration of hospital stay and mortality in patients with burns.
From a total of 1,397 studies, 13 eligible studies with 16,538 patients (3415F, 8361M) with burns were included in the analysis. Among these patients, 1702 patients had diabetes, and 14,836 patients were reported to be non-diabetic. A random effect meta-analysis revealed small-to-large size positive effect of diabetes on the infectious outcome (Hedge's g: 0.2, 95% CI: -0.03 to 0.44), overall mortality (0.16, -0.06 to 0.39), and duration of hospital stay (0.98, 0.50 to 1.45) in patients with burns.
The present systematic review and meta-analysis provides evidence regarding the high morbidity and mortality related outcomes for diabetic patients with burns. The present study confirms the findings of a previously published systematic review suggesting diabetes to be an important and independent risk factor delineating the prognostic outcome of burns.
烧伤是全球最常见的软组织损伤之一。据报道，糖尿病患者合并烧伤时，并发症、死亡率和住院相关结局的发生率更高。此外，糖尿病患者烧伤相关发病率和死亡率的相关结局。然而，自那时以来，已经发表了几项报告糖尿病患者烧伤预后作用的研究。因此，在本研究中，我们试图评估糖尿病对烧伤患者感染并发症、住院时间和死亡率相关结局的预后影响的证据现状。本研究的目的是确定糖尿病对烧伤患者感染并发症、住院时间和死亡率相关结局的总体影响。
我们根据 PRISMA 指南，在四个学术数据库（EMBASE、CENTRAL、Scopus 和 MEDLINE）中进行了系统的文献检索。采用随机效应荟萃分析评估糖尿病对烧伤患者感染并发症、住院时间和死亡率结局的汇总效应大小。
从总共 1397 项研究中，有 13 项符合条件的研究纳入了分析，共纳入 16538 名烧伤患者（3415 名女性，8361 名男性），其中 1702 名患者患有糖尿病，14836 名患者为非糖尿病患者。随机效应荟萃分析显示，糖尿病对感染结局（Hedge's g：0.2，95%CI：-0.03 至 0.44）、总死亡率（0.16，-0.06 至 0.39）和烧伤患者住院时间（0.98，0.50 至 1.45）具有小到中等大小的正向影响。
本系统评价和荟萃分析提供了糖尿病烧伤患者高发病率和死亡率相关结局的证据。本研究证实了之前发表的一项系统评价的结果，即糖尿病是描绘烧伤预后的重要且独立的危险因素。
