Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review.
OBJECTIVE
Diabetic burns patients may be at risk of worse clinical outcomes. This study aims to further investigate the impact of diabetes mellitus on clinical outcomes in burns patients in Singapore.


METHODS
A 3-year retrospective review was performed at the Singapore General Hospital Burns Centre (2011-2013). Pure inhalational burns were excluded. Diabetic (N=53) and non-diabetic (N=533) patients were compared, and the impact of diabetes on clinical outcomes, adjusting for confounders, was investigated using multivariate logistic regression.


RESULTS
The diabetic group had a significantly higher incidence of wound infection and severe renal impairment, as well as a longer length of stay, higher number of operations and higher rate of unplanned readmission. ICU admission was significantly associated with hyperglycaemia (OR 5.44 [2.61-11.35], p<0.001) and a higher total body surface area of burn (OR per 1% TBSA 1.07 [1.05-1.09], p<0.001). Unplanned readmission was significantly associated with wound infection (OR 4.29 [1.70-10.83], p=0.002), and mortality associated with a higher TBSA (OR per 1% TBSA 1.1 [1.07-1.14], p<0.001). After adjusting for confounders, diabetes mellitus was not significantly associated with unplanned readmission or mortality.


CONCLUSIONS
Diabetic burns patients have an increased risk of worse clinical outcomes, including wound infections, renal impairment and longer length of stay.
Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
Zhao-Kai
ZK
Low
Division of Research, Singapore General Hospital, 226 Outram Road Blk A Level 2, Singapore 169039, Singapore.
Wai-Yee
WY
Ng
Division of Research, Singapore General Hospital, 226 Outram Road Blk A Level 2, Singapore 169039, Singapore; Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore.
Stephanie
S
Fook-Chong
Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Bien-Keem
BK
Tan
Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Si-Jack
SJ
Chong
Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Jolie
J
Hwee
Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. Electronic address: tay.sook.muay@sgh.com.sg.
Sook-Muay
SM
Tay
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002056:Burns / Q000453:epidemiology* / Q000378:metabolism; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051437:Renal Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D062606:Tertiary Care Centers; D014946:Wound Infection / Q000453:epidemiology*; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Asia; Burn; Clinical outcome(s); Diabetes mellitus; Renal impairment; Wound infection