Systematic review and meta-analysis of complications and outcomes of obese patients with burns

•Obese patients with burns are at higher odds of longer length of stay in hospital.•Obese patients with burns are at higher odds of mortality.•Obese patients with burns are not at higher odds of infections.•Obese patients with burns are not at higher odds of increased burn operations.

Obesity has been described as a factor that contributes to poorer outcomes and more severe complications in burned patients. We thus aimed to meta-analyse the literature present regarding the extent to which obesity contributes to the prevalence of various complications in burns. We searched MEDLINE, Science Direct and Web of Science for 363 articles. Eventually, we selected only 7 articles for our analysis based on our selection criteria. Data was analysed via Review Manager 5.3, using Mantel-Haenszel statistics and random effect models. Length of stay and mortality rates were significantly different for obese patients compared to non-obese patients at a Mean Difference (MD) of 2.16 (95% CI = 0.42-3.87; I2 = 0; p = 0.01) and Odds Ratio (OR) = 1.97 (95% CI = 1.07-3.46; I2 = 65%; p = 0.03) respectively. Number of wound infections, number of burn operations and length of ICU stay were not found to be statistically different. We postulate that our significant findings are due to the proinflammatory state and poorer glycemic control in obese patients. As our review was limited by the few articles currently available in the literature, it is suggested that more studies of high quality be performed to better understand the implications of obesity in burns.