He Chunyan, Zhou Feng, Zhou Fan, Wang Jin, Huang Wei
Department of Endocrinology, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Department of Nutrition, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Int Wound J. 2023 Sep 29;21(2). doi: 10.1111/iwj.14422.
The escalating prevalence of type 2 diabetes raises concerns about adverse postoperative outcomes like surgical site infections (SSIs) and deep vein thrombosis (DVT) in orthopaedic surgeries. This meta-analysis aims to resolve inconclusive evidence by systematically quantifying the risks in type 2 diabetic patients compared to non-diabetic individuals.
The meta-analysis was conducted adhering to the PRISMA guidelines and based on the PICO framework. Four primary databases were searched: PubMed, Embase, Web of Science and the Cochrane Library, with no temporal restrictions. Studies included were either prospective or retrospective cohort studies published in English or Chinese, which assessed orthopaedic surgical outcomes among adult type 2 diabetic and non-diabetic patients. The meta-analysis employed the Newcastle-Ottawa Scale for quality assessment and used both fixed-effect and random-effects models for statistical analysis based on the level of heterogeneity.
Out of 951 identified articles, nine studies met the inclusion criteria. The odds ratio (OR) for developing postoperative SSIs among diabetic patients was 1.63 (95% CI: 1.19-2.22), indicating a significantly elevated risk compared to non-diabetic subjects. Conversely, no statistically significant difference in the risk of postoperative DVT was found between the two groups (OR: 0.82; 95% CI: 0.55-1.22). Sensitivity analysis confirmed the stability of these outcomes.
Patients with type 2 diabetes are at a higher risk of developing SSIs post orthopaedic surgery compared to non-diabetic individuals. However, both groups demonstrated comparable risks for developing postoperative DVT.
2型糖尿病患病率不断上升，引发了人们对骨科手术中术后不良结局（如手术部位感染（SSIs）和深静脉血栓形成（DVT））的担忧。本荟萃分析旨在通过系统量化2型糖尿病患者与非糖尿病个体相比的风险，解决证据不确凿的问题。
本荟萃分析遵循PRISMA指南并基于PICO框架进行。检索了四个主要数据库：PubMed、Embase、科学网和考克兰图书馆，无时间限制。纳入的研究为以英文或中文发表的前瞻性或回顾性队列研究，评估成年2型糖尿病和非糖尿病患者的骨科手术结局。荟萃分析采用纽卡斯尔-渥太华量表进行质量评估，并根据异质性水平使用固定效应模型和随机效应模型进行统计分析。
在951篇检索到的文章中，9项研究符合纳入标准。糖尿病患者术后发生SSIs的比值比（OR）为1.63（95%CI：1.19-2.22），表明与非糖尿病受试者相比风险显著升高。相反，两组术后DVT风险无统计学显著差异（OR：0.82；95%CI：0.55-1.22）。敏感性分析证实了这些结果的稳定性。
与非糖尿病个体相比，2型糖尿病患者骨科手术后发生SSIs的风险更高。然而，两组术后发生DVT的风险相当。
