Risk factors for surgical site infections following hepatobiliary surgery: An umbrella review and meta-analyses

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-11-17 DOI:10.1016/j.ejso.2024.109468

Madeline Bone (PhD Candidate) , Sharon Latimer , Rachel M. Walker , Lukman Thalib , Brigid M. Gillespie

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引用次数: 0

Abstract

Background

In the hepatobiliary (HPB) surgical cohort, surgical site infections (SSI) can extend hospital stays, result in higher morbidity, and poor patient outcomes. This umbrella review and meta-analysis aimed to synthesise the evidence for the association between clinical and patient risk factors and SSI in patients following HPB surgery.

Methods

We searched MEDLINE, CINAHL, EMBASE and Scopus from January 2000 to April 2023 to identify systematic reviews and meta-analyses where patient and/or clinical factors of SSIs following HPB surgery were reported. The summary effect size, its 95 % CI and the 95 % PI were calculated for each meta-analysis using random-effects models. 30-day cumulative SSI incidence was presented as the pooled estimate with 95 % CIs. Between-study heterogeneity was explored using the I² statistic.

Results

Nine systematic reviews and meta-analyses were included. Our findings suggest open surgical approach, type of pancreas procedure, preoperative biliary drainage, older age, male sex and high BMI (>25mg/k²) as statistically significant factors for increasing a patient's risk of SSI following HPB surgery. The cumulative incidence of SSI in the HPB cohort of 43,296 was 11 % (95 % CI 6%–20 %), with substantial variation between the reviews.

Conclusion

We identified several patient and clinical factors, however only one was graded as a high level of evidence.

查看原文本刊更多论文

肝胆手术后手术部位感染的风险因素：综述和荟萃分析。

背景：在肝胆（HPB）手术人群中，手术部位感染（SSI）会延长住院时间、导致更高的发病率和不良的患者预后。本综述和荟萃分析旨在综合临床和患者风险因素与肝胆外科手术患者 SSI 之间关系的证据：方法：我们检索了 2000 年 1 月至 2023 年 4 月期间的 MEDLINE、CINAHL、EMBASE 和 Scopus，以确定报道 HPB 手术后 SSI 患者和/或临床因素的系统综述和荟萃分析。使用随机效应模型计算了每项荟萃分析的总效应大小、95 % CI 和 95 % PI。30 天累积 SSI 发生率以汇总估计值的形式列出，并附有 95 % CIs。使用 I2 统计量分析研究间的异质性：结果：共纳入九篇系统综述和荟萃分析。我们的研究结果表明，开腹手术方式、胰腺手术类型、术前胆道引流、年龄较大、男性和高体重指数（>25mg/k2）是增加 HPB 手术后患者 SSI 风险的重要统计学因素。在43,296例HPB队列中，SSI的累计发生率为11%（95% CI 6%-20%），不同回顾之间存在很大差异：我们发现了多个患者和临床因素，但只有一个被评为高证据等级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.