Systematic review and meta-analysis of complications and outcomes of obese patients with burns

被引:17
作者
Sayampanathan, A. A. [1 ]
机构
[1] Natl Univ Singapore, Yong Loo Lin Sch Med, 1E Kent Ridge Rd,NUHS Tower Block,Level 11, Singapore 119228, Singapore
关键词
Obesity; Burn; Trauma; Complications; Outcomes; Surgery; Review; INSULIN-RESISTANCE; METABOLIC SYNDROME; MORBID-OBESITY; PROINFLAMMATORY RESPONSE; MURINE MODEL; MORTALITY; OVERWEIGHT; RISK; INTERFERON; PREVALENCE;
D O I
10.1016/j.burns.2016.05.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Obesity has been described as a factor that contributes to poorer outcomes and more severe complications in burned patients. We thus aimed to meta-analyse the literature present regarding the extent to which obesity contributes to the prevalence of various complications in burns. We searched MEDLINE, Science Direct and Web of Science for 363 articles. Eventually, we selected only 7 articles for our analysis based on our selection criteria. Data was analysed via Review Manager 5.3, using Mantel-Haenszel statistics and random effect models. Length of stay and mortality rates were significantly different for obese patients compared to non-obese patients at a Mean Difference (MD) of 2.16 (95% CI = 0.42-3.87; I-2 = 0; p = 0.01) and Odds Ratio (OR) = 1.97 (95% CI = 1.07-3.46; I-2 = 65%; p = 0.03) respectively. Number of wound infections, number of burn operations and length of ICU stay were not found to be statistically different. We postulate that our significant findings are due to the proinflammatory state and poorer glycemic control in obese patients. As our review was limited by the few articles currently available in the literature, it is suggested that more studies of high quality be performed to better understand the implications of obesity in burns. (C) 2016 Elsevier Ltd and ISBI. All rights reserved.
引用
收藏
页码:1634 / 1643
页数:10
相关论文
共 60 条
[1]  
[Anonymous], 2014, REV MAN REVMAN COMP
[2]  
[Anonymous], 2000, WHO TECHN REP SER
[3]   OBESITY, ATHEROSCLEROSIS, AND CORONARY-ARTERY DISEASE [J].
BARRETTCONNOR, EL .
ANNALS OF INTERNAL MEDICINE, 1985, 103 (06) :1010-1019
[4]   Obesity prevalence from a European perspective:: a systematic review [J].
Berghoefer, Anne ;
Pischon, Tobias ;
Reinhold, Thomas ;
Apovian, Caroline M. ;
Sharma, Arya M. ;
Willich, Stefan N. .
BMC PUBLIC HEALTH, 2008, 8 (1)
[5]  
Bochicchio GV., J Am Coll Surg
[6]   How long a shadow does epidemic obesity cast in the burn unit? A dietitian's analysis of the strengths and weaknesses of the available data in the National Burn Repository [J].
Carpenter, Annette M. ;
Hollett, Lori P. ;
Jeng, James C. ;
Wu, Jingshu ;
Turner, Dale G. ;
Jordan, Marion H. .
JOURNAL OF BURN CARE & RESEARCH, 2008, 29 (01) :97-101
[7]  
Christmas AB, 2007, AM SURGEON, V73, P1122
[8]   Obesity increases risk of organ failure after severe trauma [J].
Ciesla, David J. ;
Moore, Ernest E. ;
Johnson, Jeffery L. ;
Burch, Jon M. ;
Cothren, C. Clay ;
Sauaia, Angela .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2006, 203 (04) :539-545
[9]   Morbid Obesity is Not a Risk Factor for Mortality in Critically ill Trauma Patients [J].
Diaz, Jose J., Jr. ;
Norris, Potrick R. ;
Collier, Bryan R. ;
Berkes, Marschall B. ;
Ozdas, Asli ;
May, Addison K. ;
Miller, Richard S. ;
Morris, John A., Jr. .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2009, 66 (01) :226-231
[10]   EXCESSIVE MORTALITY AND CAUSES OF DEATH IN MORBIDLY OBESE MEN [J].
DRENICK, EJ ;
BALE, GS ;
SELTZER, F ;
JOHNSON, DG .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1980, 243 (05) :443-445