Abstract
Uncertainty exists about the role of diabetes in the development of surgery-related pressure ulcers. Therefore, we conducted a meta-analysis to explore the association between pre-existing diabetes mellitus and pressure ulcers among patients after surgery. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random effects models. Thirteen eligible studies of 2367 patients in total and 12053 controls were included in the final analysis. Compared with patients without diabetes, the pooled odds ratio (OR) of the incidence of pressure ulcers in diabetic patients was 1.74 [95% confidence interval (CI) = 1.40–2.15, I2 = 51.1%]. Estimates by type of surgery suggested similar results in cardiac surgery [OR = 2.00, 95% CI = 1.42–2.82, I2 = 0%], in general surgery [OR = 1.75, 95% CI = 1.42–2.15, I2 = 0%], and in major lower limb amputations [OR = 1.65, 95% CI = 1.01–2.68, I2 = 0%] for diabetic patients versus non-diabetic controls. We did not find an increased incidence of pressure ulcers in diabetic patients undergoing hip surgery compared with non-diabetic controls [OR = 1.46, 95% CI = 0.62–3.47, I2 = 93.1%]. The excess risk of pressure ulcers associated with pre-existing diabetes was significantly higher in patients undergoing surgery, specifically in patients receiving cardiac surgery. Further studies should be conducted to examine these associations in other types of surgery.
Highlights
Uncertainty exists about the role of diabetes in the development of surgery-related pressure ulcers
Several studies have focused on the association between diabetes mellitus and surgery-related pressure ulcers; these published reports have varied by incidence, type of surgery, and risk factors, among other reasons
Our updated meta-analysis suggested that diabetes mellitus may lead to a higher risk of perioperative pressure ulcers
Summary
Uncertainty exists about the role of diabetes in the development of surgery-related pressure ulcers. We conducted a meta-analysis to explore the association between pre-existing diabetes mellitus and pressure ulcers among patients after surgery. We did not find an increased incidence of pressure ulcers in diabetic patients undergoing hip surgery compared with non-diabetic controls [OR = 1.46, 95% CI = 0.62–3.47, I2 = 93.1%]. Several studies have focused on the association between diabetes mellitus and surgery-related pressure ulcers; these published reports have varied by incidence, type of surgery, and risk factors, among other reasons. We undertook an updated and extended analysis that incorporated additional previous and more recent data to further assess diabetes as a risk factor for pressure ulcers in patients undergoing different types of surgery
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