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Meta-Analysis
. 2014 Feb 27;9(2):e90426.
doi: 10.1371/journal.pone.0090426. eCollection 2014.

Risk of acute lung injury/acute respiratory distress syndrome in critically ill adult patients with pre-existing diabetes: a meta-analysis

Wan-Jie Gu  1 , You-Dong Wan  2 , Hong-Tao Tie  3 , Quan-Cheng Kan  4 , Tong-Wen Sun  2
Affiliations
Meta-Analysis

Risk of acute lung injury/acute respiratory distress syndrome in critically ill adult patients with pre-existing diabetes: a meta-analysis

Wan-Jie Gu et al. PLoS One. .

Abstract

Background: The impact of pre-existing diabetes on the development of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in critically ill patients remains unclear. We performed a meta-analysis of cohort studies to evaluate the risk of ALI/ARDS in critically ill patients with and without pre-existing diabetes.

Materials and methods: We searched PubMed and Embase from the inception to September 2013 for cohort studies assessing the effect of pre-existing diabetes on ALI/ARDS occurrence. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using random- or fixed-effect models when appropriate.

Results: Seven cohort studies with a total of 12,794 participants and 2,937 cases of pre-existing diabetes, and 2,457 cases of ALI/ARDS were included in the meta-analysis. A fixed-effects model meta-analysis showed that pre-existing diabetes was associated with a reduced risk of ALI/ARDS (OR 0.66; 95% CI, 0.55-0.80; p<0.001), with low heterogeneity among the studies (I(2)=18.9%; p=0.286). However, the asymmetric funnel plot and Egger's test (p=0.007) suggested publication bias may exist.

Conclusions: Our meta-analysis suggests that pre-existing diabetes was associated with a decreased risk of ALI/ARDS in critically ill adult patients. However, the result should be interpreted with caution because of the potential bias and confounding in the included studies.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram for selection of articles.
Figure 2
Figure 2. Forest plot showing the risk of ALI/ARDS in critically ill adult patients with pre-existing diabetes.
Figure 3
Figure 3. Funnel plot for the risk of ALI/ARDS in critically ill adult patients with pre-existing diabetes.or, risk ratio. s.e., standard error.
See this image and copyright information in PMC

References

    1. Rubenfeld GD, Herridge MS (2007) Epidemiology and outcomes of acute lung injury. Chest 131: 554–562. - PubMed
    1. King H, Aubert RE, Herman WH (1998) Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 21: 1414–1431. - PubMed
    1. Cartin-Ceba R, Kashiouris M, Plataki M, Kor DJ, Gajic O, et al. (2012) Risk factors for development of acute kidney injury in critically ill patients: a systematic review and meta-analysis of observational studies. Crit Care Res Pract 2012: 691013. - PMC - PubMed
    1. Christiansen CF, Johansen MB, Christensen S, O'Brien JM, Tonnesen E, et al. (2013) Type 2 diabetes and 1-year mortality in intensive care unit patients. Eur J Clin Invest 43: 238–247. - PubMed
    1. Siegelaar SE, Hickmann M, Hoekstra JB, Holleman F, DeVries JH (2011) The effect of diabetes on mortality in critically ill patients: a systematic review and meta-analysis. Crit Care 15: R205. - PMC - PubMed

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