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. 2018 Mar;44(2):272-279.
doi: 10.1016/j.burns.2017.09.022. Epub 2017 Oct 10.

Burn injury outcomes in patients with pre-existing diabetic mellitus: Risk of hospital-acquired infections and inpatient mortality

Laquanda Knowlin  1 , Paula D Strassle  2 , Felicia N Williams  1 , Richard Thompson  1 , Samuel Jones  1 , David J Weber  3 , David van Duin  3 , Bruce A Cairns  1 , Anthony Charles  4
Affiliations

Burn injury outcomes in patients with pre-existing diabetic mellitus: Risk of hospital-acquired infections and inpatient mortality

Laquanda Knowlin et al. Burns. 2018 Mar.

Abstract

Background: Diabetes mellitus (DM) is a major cause of illness and death in the United States, and diabetic patients are at increased risk for burn injury. We therefore sought to examine the impact of pre-existing DM on the risk of inpatient mortality and hospital acquired infections (HAI) among burn patients.

Methods: Adult patients (≥18 years old) admitted from 2004 to 2013 were analyzed. Weighted Kaplan-Meier survival curves - adjusting for patient demographics, burn mechanism, presence of inhalation injury, total body surface area, additional comorbidities, and differential lengths of stay - were used to estimate the 30-day and 60-day risk of mortality and HAIs.

Results: A total of 5539 adult patients were admitted and included in this study during the study period. 655 (11.8%) had a pre-existing DM. The crude incidence of HAIs and in-hospital mortality for the whole burn cohort was 8.5% (n=378) and 4.4% (n=243), respectively. Diabetic patients were more likely to be older, female, have additional comorbidities, inhalational injury, and contact burns. After adjusting for patient and burn characteristics, the 60-day risk of HAI among patients with DM was significantly higher, compared to non-diabetic patients (RR 2.07, 95% CI 1.28, 6.79). However, no significant difference was seen in the 60-day risk of mortality (RR 1.34, 95% CI 0.44, 3.10).

Conclusions: Pre-existing DM significantly increases the risk of developing an HAI in patients following burn injury, but does not significantly impact the risk of inpatient mortality. Further understanding of the immune modulatory mechanism of burn injury and DM is imperative to better attenuate the acquisition of HAIs.

Keywords: Burns; Diabetes mellitus; Hospital acquired infections; Outcomes.

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Conflict of interest statement

Conflict of interest

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
(A) Crude and (B) stabilized 60-day cumulative incidence of inpatient mortality among patients with diabetes (dashed) and without diabetes (solid).
Fig. 2
Fig. 2
(A) Crude and (B) stabilized 60-day cumulative risk of hospital-acquired infection (HAI) among patients with diabetes (dashed) and without diabetes (solid) among adult burn patients admitted to the unit for ≥2 days.
See this image and copyright information in PMC

References

    1. American Diabetes Association. Economic costs of diabetes in the US in 2012. Diabetes Care. 2013;36(4):1033–46. - PMC - PubMed
    1. Geiss LS, Wang J, Cheng YJ, Thomspon TJ, Barker L, Li Y, et al. Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980–2012. JAMA. 2014;312(12):1218–26. - PubMed
    1. Thng P, Lim RM, Low BY. Thermal burns in diabetic feet. Singap Med J. 1999;40:362–4. - PubMed
    1. Maghsoudi H, Pourzand A, Azarmir G. Etilogy and outcome of burns in Tabriz, Iran: an analysis of 2963 cases. Scand J Surg. 2005;94:77–81. - PubMed
    1. Bill TJ, Edlich RF, Himel HN. Electric heating pad burns. J Emerg Med. 1994;12:819–24. - PubMed

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