Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review

Low, Z.K.; Ng, Wai-Yee; Fook‐Chong, Stephanie; Tan, Bien-Keem; Chong, Shan; Hwee, Jolie; Tay, Sook Muay

doi:10.1016/j.burns.2016.06.004

Cited by 14 publications

(8 citation statements)

References 25 publications

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“…In patients of DM, the risk of worse clinical outcomes during admission, including wound infections, renal function impairment and longer LOS increase significantly 12 . Preoperative HbA1c may be an apparent risk factor of post-operative complications, especially higher HbA1c related to infection were also revealed in surgical intervention of gynaecological cancer 13 .…”

Section: Discussionmentioning

confidence: 99%

High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

Hsieh

2019

Sci Rep

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Glucose variability is common among hospitalized patients with type 2 diabetes mellitus (DM). I investigated to assess the variability of glucose in patients with type 2 DM accounts for in-hospital readmission rates in department of Surgery. I retrospectively analyzed 206 patients with type 2 DM, who was admitted to our hospital for surgical interventions and re-admitted within 30 days after discharge. I also enrolled 610 age, sex and diabetic duration matched patients with type 2 DM, as control. Outcomes measure included average and standard deviation (SD) of blood glucose during admission, glycated hemoglobin (HbA1c), lipid profile, renal function, length of stay (LOS). Patients who had re-admission within 30 days after discharge had higher SD of blood glucose levels than control (84.7 ± 53.5 mg/dL vs. 46.2 ± 42.8 mg/dL, p < 0.001) but not average of blood glucose levels. Comparing to control group, the study group also had higher HbA1c (8.4 ± 1.3% vs. 7.7 ± 1.1%, p = 0.015) and LOS (8.5 ± 2.5 days vs 7.0 ± 1.5 days, p = 0.020). The independent predictors of 30-day readmission rates were SD of blood glucose during admission and HbA1c (hazard ratio: 1.680, 1.493; p value < 0.001, 0.008, respectively). Decreasing glucose variability during admission for surgery is important for patients with type 2 DM to decreasing re-admission rates and LOS. HBA1c may also identify patients at higher risk of postoperative complications and possibility of re-admission.

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Section: Discussionmentioning

confidence: 99%

High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

Hsieh

2019

Sci Rep

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“…Both PH 2.5% and PH 5% exhibited a comparatively greater zone of inhibition than MEBO ® , with results of 0.61 ± 0.01, 0.77 ± 0.01, and 0.33 ± 0.01 mm, respectively ( Figure 8 ). The results suggested that drug-free pectin hydrogel can protect wounds from infection and prevent microorganisms from reaching the wound area [ 8 ]. The antimicrobial activity of pectin, coupled with its ability to maintain an acidic environment, is expected to act as a barrier against microorganisms and limit their microbial activities [ 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…The management of burn wounds in patients who have poor wound healing progress is one of the greatest problems in therapeutic treatment [ 7 ]. Based on a retrospective review by Low et al [ 8 ], burn patients with diabetes have a higher risk of wound infections and longer lengths of stay in health facilities compared to non-diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Drug-Free Pectin Hydrogel Films on Thermal Burn Wounds in Streptozotocin-Induced Diabetic Rats

et al. 2022

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This study aims to examine the influence of drug-free pectin hydrogel films on partial-thickness burn wounds using streptozotocin-induced diabetic rats as the animal model. Thirty male Sprague Dawley rats were included in the wound healing study, and scalding water was used to produce wounds in the dorsum region of the rats. Two different formulations of pectin hydrogel films, PH 2.5% and PH 5%, were prepared using a solvent evaporation method. MEBO® (moist exposed burn ointment), a commercial herbal formulation was used as a positive control. The progress of the wound healing was observed and compared between untreated normal rats, untreated diabetic rats, diabetic rats treated with MEBO®, diabetic rats treated with PH 2.5%, and diabetic rats treated with PH 5%. The results showed that diabetic rats treated with PH 5% healed faster than the untreated diabetic rats and diabetic rats treated with PH 2.5%. Interestingly, the diabetic rats treated with PH 5% healed as well as diabetic rats treated with MEBO®, where wounds were healed entirely on day 20. Nevertheless, both PH 2.5% and PH 5% showed a greater zone of inhibition than MEBO® when tested against Staphylococcus aureus.

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“…Previous studies have repeatedly failed to show the effect of DM on the mortality of burn patients 2,3,7,8 . Several reports of increased morbidities in burn patients with DM were also based on the results of simple comparisons between those with and without DM without adjustment for confounding factors 2,3,7-10 .…”

Section: Discussionmentioning

confidence: 99%

“…For recovery from burn injury, however, sufficient circulatory support, satisfactory restoration of the wound site, and protection against infection are required to prevent complications involving various organ systems. Thus burn patients with DM, in particular, may be at increased risk of unfavorable outcomes or complications 3 . Previous studies have shown that DM increases mortality, complications, and the duration of intensive care unit stay and ventilator support among trauma patients 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Effects of Diabetes Mellitus on the Mortality, Length of Hospital Stay and Number of Operations in Burn Patients

2019

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Background: The effects of diabetes mellitus (DM) on mortality and morbidities in burn patients have not been sufficiently elucidated. Objective: The present study aimed to investigate the effects of DM on the mortality, length of hospital stay, and number of operations in burn patients. Methods: A retrospective cohort study was performed using medical records of 3,220 burn patients. Multiple logistic regression, linear regression, and Poisson regression models were used to determine whether DM increases mortality in patients with burn injury, whether DM prolongs length of hospital stay in burn survivors, and whether DM increases the number of operations in burn survivors, respectively. Results: After adjusting for potential confounding factors, DM significantly increased odds of death in burn patients (adjusted odds ratio 3.225 [95% confidence interval 1.405∼7.400], p=0.006). DM also increased the mean length of hospital stay in burn survivors (adjusted mean ratio 1.312 [95% confidence interval 1.198∼1.437], p＜0.001). Furthermore, DM significantly increased the mean number of operations in burn survivors (adjusted mean ratio 1.576 [95% confidence interval 1.391∼ 1.785], p＜0.001). Conclusion: DM increases mortality, elongates hospital stay and makes more operations required in patients with burn injury. (Ann Dermatol 31(1) 51∼58, 2019

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Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review

Cited by 14 publications

References 25 publications

High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

Effects of Drug-Free Pectin Hydrogel Films on Thermal Burn Wounds in Streptozotocin-Induced Diabetic Rats

Effects of Diabetes Mellitus on the Mortality, Length of Hospital Stay and Number of Operations in Burn Patients

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