Diabetes Mellitus as a Risk Factor for Surgery-Related Pressure Ulcers: A Meta-analysis

PURPOSE: The purpose of this study was to determine whether diabetes mellitus is associated with increased likelihood of surgery-related (perioperative) pressure ulcers. METHODS: The MEDLINE and Thomson Reuters Web of Knowledge electronic databases were searched for studies of diabetes as a risk factor for surgery-related pressure ulcers in case-control or cohort design; studies were limited to those published in English. Data from studies meeting inclusion criteria were pooled, and a meta-analysis was completed using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Odds ratios for surgery-related pressure ulcers were calculated for patients with and without diabetes mellitus. RESULTS: Six observational studies were identified involving a total of 2453 patients. When compared to patients with normal glucose tolerance, persons with diabetes mellitus were more likely to experience surgery-related pressure ulcers (odds ratio 5 2.15; 95% confidence interval: 1.62–2.84). CONCLUSION: Our meta-analysis indicates that patients with diabetes mellitus are slightly more than twice as likely to develop surgery-related pressure ulcers as compared to patients with normal glucose tolerance.

[1]  Marjorie Funk,et al.  Factors Associated With Pressure Ulcers in Patients in a Surgical Intensive Care Unit , 2010, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[2]  D. Kring Reliability and Validity of the Braden Scale for Predicting Pressure Ulcer Risk , 2007, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[3]  H. Frankel,et al.  Risk Factors for Pressure Ulcer Development in a Best Practice Surgical Intensive Care Unit , 2007, The American surgeon.

[4]  A. Schultz,et al.  Etiology and incidence of pressure ulcers in surgical patients. , 1999, AORN journal.

[5]  G. Smith,et al.  Meta-analysis Spurious precision? Meta-analysis of observational studies , 1998, BMJ.

[6]  M. Secic,et al.  Patient risk factors for pressure ulcers during cardiac surgery. , 1997, AORN journal.

[7]  M. Swanson,et al.  Skin care intervention for patients having cardiac surgery. , 2003, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[8]  M. Unosson,et al.  Pressure ulcer risk factors in patients undergoing surgery. , 2005, Journal of advanced nursing.

[9]  Lisette Schoonhoven,et al.  Incidence of pressure ulcers due to surgery. , 2002, Journal of clinical nursing.

[10]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology - A proposal for reporting , 2000 .

[11]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[12]  J. Whitney,et al.  Development of a Risk Assessment Tool for Intraoperative Pressure Ulcers , 2005, Journal of Wound, Ostomy and Continence Nursing (WOCN).

[13]  S. Stordeur,et al.  The importance of repeated risk assessment for pressure sores in cardiovascular surgery. , 1998, The Journal of cardiovascular surgery.

[14]  Jonathan A C Sterne,et al.  Funnel Plots in Meta-analysis , 2004 .

[15]  S. Aronovitch Intraoperatively acquired pressure ulcer prevalence: a national study. , 1998, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.