The impact of diabetes mellitus on mortality and infection outcomes in burn patients: a meta-analysis

B. Yang, Y.-Q. Cai, X.-D. Wang

Department of Burn Plastic Surgery, The Fourth People’s Hospital of Jinan, Jinan, Shandong Province, P.R. China. xdwang71974@163.com

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• Plastic Surgery

OBJECTIVE: 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.

MATERIALS AND METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

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