The effect of diabetes on the risk and mortality of acute lung injury/acute respiratory distress syndrome A meta-analysis

Background: The role of pre-existing diabetes in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is still controversial. This systematic review and meta-analysis of observational studies aimed to evaluate the effect of diabetes on the risk and mortality of ALI/ARDS. Methods: A comprehensive literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trails and Web of Science for their inception to September 2018. Summary risk estimates were calculated with a DerSimonian and Laird random-effects model. Heterogeneity was evaluated using Cochran chi-square test and the I-2 statistic. Results: Ultimately, 14 studies with a total of 6613ALI/ARDS cases were included. The risk of ALI/ARDS was not significantly reduced in diabetes patients (OR 0.82, 95% CI 0.57-1.18, P=.283), with obvious heterogeneity across studies (I-2=72.5%, P<.001). Further analyses in the meta-analysis also showed no statistically significant associations between pre-existing diabetes and in-hospital mortality (OR 0.79, 95% CI 0.51-1.21, P=.282) or 60-day mortality of ALI/ARDS (OR 0.91, 95% CI 0.75-1.11, P=.352). Conclusion: This systematic review and meta-analysis of observational studies indicates that pre-existing diabetes have no effect on the risk and mortality of ALI/ARDS.