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BACKGROUND: The impact of type 2 diabetes mellitus (T2DM) on acute respiratory distress syndrome (ARDS) is debatable. T2DM was suspected to reduce the risk and complications of ARDS. However, during coronavirus disease 2019 (COVID-19), T2DM predisposed patients to ARDS, especially those who were on insulin at home. AIM: To evaluate the impact of outpatient insulin use in T2DM patients on non-COVID-19 ARDS outcomes. METHODS: We conducted a retrospective cohort analysis using the Nationwide Inpatient Sample database. Adult patients diagnosed with ARDS were stratified into insulin-dependent diabetes mellitus (DM) (IDDM) and non-insulin-dependent DM (NIDDM) groups. After applying exclusion criteria and matching over 20 variables, we compared cohorts for mortality, duration of mechanical ventilation, incidence of acute kidney injury (AKI), length of stay (LOS), hospitalization costs, and other clinical outcomes. RESULTS: Following 1:1 propensity score matching, the analysis included 274 patients in each group. Notably, no statistically significant differences emerged between the IDDM and NIDDM groups in terms of mortality rates (32.8% vs 31.0%, P = 0.520), median hospital LOS (10 d, P = 0.537), requirement for mechanical ventilation, incidence rates of sepsis, pneumonia or AKI, median total hospitalization costs, or patient disposition upon discharge. CONCLUSION: Compared to alternative anti-diabetic medications, outpatient insulin treatment does not appear to exert an independent influence on in-hospital morbidity or mortality in diabetic patients with non-COVID-19 ARDS.
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Introduction Despite the heightened interest in the management and prevention of burn scars, only a few articles have been published that assess the risk factors for the development of burn scars. The relationship between admission to the burn unit and the need for reconstructive surgery, the effect of the burn area on the number of further surgeries needed, and the adverse event of the technique used in the reconstructive surgery is not widely explored in the literature. These unmet challenges are crucial for a standardized consensus about burn scar management. Methods A retrospective study of patients admitted for burn reconstructive surgeries was conducted. A total of 100 patients (mean age: 29 years old) were included in this study. Data were retrospectively collected by reviewing the patients' charts. Data were analyzed using the SPSS software, version 25.00 (SPSS Inc., Chicago, IL). Results The most common surgery performed was a release contracture with skin grafting (n = 93.93%). No significant difference was reported between the patient's age and the total number of surgeries. A significant difference was noted between the different techniques used and the total number of surgeries. Patients with release contracture surgery had higher scores of satisfaction and better functional outcome. Conclusion The most common surgery performed for scar treatment was contracture release coupled with skin grafting. The most common cause of burn in Lebanon was flame, and the most commonly affected anatomical area was the upper limb. Further studies recruiting patients from all over Lebanon and assessing their characteristics are now warranted.