Impact of diabetes mellitus on clinical outcome in burns patients managed in a national burns centre.

BACKGROUND

The impact of diabetes mellitus on outcomes following burn injury remains unclear. This study aimed to characterise diabetic burn patients and their outcomes at a national burns centre.

METHODS

A retrospective cohort study was performed at the National Burns Unit, St. James's Hospital, Dublin, reviewing admissions from 2012 to 2022. Patients with complete data (n = 870) were divided into diabetic (n = 55) and non-diabetic (n = 815) groups. Demographics, comorbidities, injury characteristics, complications, length of stay and mortality were compared. Multivariable logistic regression was conducted to determine the association between diabetes and mortality, adjusting for age and total body surface area (TBSA).

RESULTS

Diabetic patients were older (mean age 65.6 vs 47.8 years, p <0.001) and had increased rates of cardiovascular, respiratory and renal comorbidities. They experienced more complications including acute decompensated heart failure, acute kidney injury and urinary tract infection. Median length of stay was longer (13 vs 9 days, p <0.001). Mortality was higher in diabetic patients on univariable analysis (13% vs 4.4%; OR 3.16, 95% CI 1.33 - 7.46, p = 0.009). However, after adjusting for age and TBSA, diabetes was no longer significantly associated with mortality (Adjusted OR 1.29, 95% CI 0.41 - 4.10, p = 0.667).

CONCLUSION

At Ireland's national burns centre, diabetic burn patients were older, more comorbid, suffered greater morbidity and required longer hospital stays. Their higher mortality rate may be attributable to increased age rather than diabetes itself. These single-centre findings require confirmation elsewhere.