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

// Mining Liang 1, * , Qiongni Chen 2, * , Yang Zhang 3 , Li He 1 , Jianjian Wang 1 , Yiwen Cai 1 , Lezhi Li 2 1 Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China 2 Department of Nursing, The Second Xiangya Hospital, Central South University, Hunan Province, Changsha, China 3 Nursing Teaching and Research Institute, Medical College of Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China * These authors contributed equally to this work Correspondence to: Lezhi Li, email: llz6511@126.com Keywords: diabetes, bedsore, surgery, meta-analysis Received: November 26, 2016 Accepted: December 21, 2016 Published: December 27, 2016 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.