Impact of diabetes on the risk of bedsore in patients undergoing surgery: an updated quantitative analysis of cohort studies

Abstract

Diabetes is a major cause of morbidity for patients undergoing surgery and can increase the incidence of some postoperative complications such as bedsores. We conducted a meta-analysis of observational studies to examine whether patients with diabetes undergoing surgery had high risk of bedsore. We performed a systematic literature search in Pubmed, Embase and the Cochrane Library Central Register of Controlled Trials database from inception to November 2016. Studies were selected if they reported estimates of the relative risk (RR) for bedsore risk in postoperative diabetic patients compared with that of in non-diabetic patients. Random-effects meta-analysis was conducted to pool the estimates. A total of 16 studies with 24,112 individuals were included in our meta-analysis. The pooled RR of bedsore development for patients with diatetes was 1.77 (95% CI 1.45 to 2.16). The results of subgroup analyses were consistent when stratified by surgery type, study design, research region, sample size, inclusion period, analysis method and study quality. There was evidence of publication bias among studies and a sensitivity analysis using the Duval and Tweedie “trim-and-fill” method did not significantly alter the pooled results (adjusted RR 1.17, 95% CI 1.02 to 1.36).This meta-analysis provides indications that diabetic patients undergoing surgery could have a higher risk of developing bedsores. Further large-scale prospective trials should be implemented to comfirm the association.

Efficacy and Safety of Ginkgo Leaf Extract and Dipyridamole Injection for Ischemic Stroke: A Systematic Review and Meta Analysis

“…Publication bias was numerically examined by Begg’s and Egger’s tests and presented by funnel plots. If publication bias existed, we used the trim-and-fill method to adjust the pooled estimates of the potential unpublished studies in the meta-analysis, which were compared with the original pooled OR (Liang et al, 2017; Lin et al, 2018). Sensitivity analysis was conducted to investigate the influence of different GDI dosages, sample sizes and research types on clinical efficacy.…”

Transcatheter hepatic arterial chemoembolization plus cinobufotalin injection adjuvant therapy for advanced hepatocellular carcinoma: a meta-analysis of 27 trials involving 2,079 patients

“…We further investigated potential sources of between-study heterogeneity by subgroup analyses based on the some baseline variables (study design and sample sizes). Publication bias was assessed visually by funnel plots and quantified in Egger’s test and Begg’s regression test 47,48. When publication bias existed, trim-and-fill method was applied to adjust the pooled estimates of potentially unpublished studies.…”

Efficacy and safety of sodium cantharidinate and vitamin B6 injection for the treatment of digestive system neoplasms: a meta-analysis of randomized controlled trials

“…Pooled analysis with publication bias determined that the trim-and-fill method would be applied to coordinate the estimates of unpublished studies, and the adjusted results were compared with the original pooled OR 48. Sensitivity analysis (subgroup analyses) was conducted to evaluate the impact of different cancer types, SC/B6 dosages, therapeutic regimens, sample sizes, and study types on clinical efficacy.…”