Review
Diabetes Mellitus and Risk of Bronchopleural Fistula After Pulmonary Resections: A Meta-Analysis

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We conducted this meta-analysis to evaluate the association between diabetes mellitus and the risk of bronchopleural fistula in patients undergoing pulmonary resection. The PubMed and EMBASE databases were searched, and 15 retrospective observational studies were included. The pooled analysis showed that diabetes mellitus was significantly associated with the formation of bronchopleural fistula after pulmonary resection (odds ratio = 1.97; 95% confidence interval = 1.39 to 2.80; p < 0.001). This association remained statistically prominent in the subgroups classified by statistical analysis, diagnoses and operative modes and in Asian patients. Therefore, diabetes mellitus can be an independent risk factor for bronchopleural fistula after pulmonary resection.

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Methods and Materials

A systematic review and meta-analysis does not require patients’ consent or ethical approval. We conducted this meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [10]. The additional PRISMA 2009 checklist is given in the Appendix, data 1.

Selection of Included Studies

The complete procedure of literature retrieval is summarized in Figure 1. A total of 1,584 citations were identified after primary retrieval, including 922 citations in PubMed and 662 citations in EMBASE. Then, 912 of these citations were initially filtered after exclusion of the duplicates. After careful screening of the titles and abstracts, 454 unqualified literature studies were directly excluded, including 119 reviews, 90 case reports, two animal experiments, 166 non-English studies, and

Comment

Meta-analysis is a well-established statistical method that integrates the appropriate data from homogeneous studies to enable global conclusions to be drawn [35]. To our knowledge, this is the first systematic review and meta-analysis to evaluate the association between DM and the risk of BPF after pulmonary resection, and it covered all the required contents for a standard PRISMA report. Considering the variations of the definition of DM over time, we determined to integrate the evidence

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