Patient Safety in Surgery最新文献

{"title":"Inherent safety risks of guidelines derived from \"cause-agnostic\" randomized controlled trials: a review.","authors":"Lawrence Lynn","doi":"10.1186/s13037-026-00486-y","DOIUrl":"10.1186/s13037-026-00486-y","url":null,"abstract":"<p><p>Physicians rely on guidelines derived from randomized controlled trials (RCTs) to determine whether interventions are safe and effective for specific diseases or causal mechanisms. In critical care, however, well-powered RCTs demonstrating clear evidence of benefit and subsequently incorporated into clinical guidelines have repeatedly been abandoned after causing harm. This strong evidence of benefit from robust RCTs or meta-analyses followed by unexpected harm during clinical application, generates an “evidence deployment paradox”, which has been attributed to unavoidable biological heterogeneity rather than to structural flaws in trial design. Recent analysis has shifted attention to the architecture of the RCT itself, indicating that the paradox arises from a mathematical set-mixing problem introduced by a modification of the original RCT model when the field adopted a trial design in which enrollment was decoupled from causal diagnosis or the targeted causal mechanism and replaced by consensus-derived, disease- and cause-agnostic triage thresholds. The triage selects broadly shifting mixtures of diseases with potentially different treatment effects. We term this design the cause-agnostic randomized controlled trial. Although cause-agnostic RCT can generate internally valid estimates within trial participants, their results may paradoxically be unsafe to incorporate into clinical guidelines, even when applied in the same hospitals and using the same entry criteria as the source trials. Structural causal modeling provides tools to mitigate this evidence-deployment paradox. Such modeling makes explicit the causal assumptions underlying enrollment and can identify when, and to what extent, a trial has deviated from cause-and-effect logic of the original randomized trial design.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proof-of-concept study for a national geriatric hip fracture registry in Brazil.","authors":"Luiz Fernando Cocco, Daniel Balbachevsky, Guilherme G Falótico, Fernando Baldy Dos Reis, Carolina Ribeiro Cocco, Carlos Eduardo Franciozi, Marcus Vinicius Malheiros Luzo","doi":"10.1186/s13037-026-00484-0","DOIUrl":"10.1186/s13037-026-00484-0","url":null,"abstract":"<p><p>BACKGROUND: Hip fractures in older adults are associated with high morbidity, mortality, and healthcare costs. Their incidence is rising with population aging, yet Brazil still lacks a unified national registry to systematically monitor these cases. METHODS: We developed a consensus-based registry protocol based on a review of national and international literature on hip fracture registries, in conjunction with alignment to the Fragility Fracture Network Minimum Common Dataset (MCD), and multidisciplinary expert consensus, adapted to the Brazilian healthcare context. REGISTRY DESIGN: The main outcome of this work is the development of a structured national hip fracture registry protocol for older adults in Brazil. Based on literature review, international registry models, and expert consensus, a standardized and tiered dataset aligned with the Fragility Fracture Network Minimum Common Dataset was developed, together with operational definitions of key variables and indicators and a national governance and implementation framework. The unified dataset presented in the HFR-Brazil – Minimum Common Dataset (FFN-aligned) – Unified Table constitutes the main outcome of this study. CONCLUSIONS: Implementing a national hip-fracture registry in Brazil is a strategic priority to improve orthogeriatric care, reduce morbidity and mortality, and align national practices with international standards. The protocol provides a pragmatic, evidence-based roadmap for nationwide adoption and for future publications reporting objective outcomes once data collection begins. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe rapidly progressing multi‑resistant polymicrobial surgical site infection after elective abdominoplasty: a case report.","authors":"Alaa A Sultan, Abdullah Ahmed Alabbasi, Muhanad Saleh Alzahrani, Mohammed Naif Alsubhi, Abdullah E Kattan, Faris Alaa Sultan, Khalid Arab","doi":"10.1186/s13037-026-00476-0","DOIUrl":"10.1186/s13037-026-00476-0","url":null,"abstract":"<p><p>BACKGROUND: Adverse events following elective cosmetic surgery can raise concerns about patient safety, particularly in facilities with variable oversight of infection‑prevention practices. Severe early‑onset postoperative infections caused by multidrug‑resistant organisms may indicate system‑level failures in sterile processing or infection control protocols. CASE PRESENTATION: We report a rapidly progressing polymicrobial multidrug‑resistant surgical site infection in a previously healthy woman seven days after elective abdominoplasty with liposuction and lipofilling. The patient experienced early clinical deterioration requiring multiple emergency debridements, intensive care admission, prolonged antimicrobial therapy, negative‑pressure wound management, and eventual skin grafting. Microbiology revealed evolving multidrug‑resistant Pseudomonas aeruginosa, ESBL‑producing Enterobacterales, Staphylococcus epidermidis, and Klebsiella species. The severity, early onset, and unusual microbiological profile raised concerns for a possible sterilization or infection‑control breach at the original surgical facility. CONCLUSION: Early severe postoperative infections following elective procedures may signal underlying system failures rather than isolated clinical complications. Strengthening sterile processing oversight, improving infection‑control auditing, and ensuring timely escalation of care are critical to preventing similar events and safeguarding patient safety. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety of radiofrequency surgical sponges in orthopedic surgery: a validation study in 2,251 arthroplasty procedures.","authors":"Jack A Will, Lachlan F Anderson, Steven Ogden","doi":"10.1186/s13037-026-00485-z","DOIUrl":"10.1186/s13037-026-00485-z","url":null,"abstract":"<p><p>BACKGROUND: Retained foreign objects (RFOs), particularly surgical sponges, remain a serious yet preventable source of morbidity and litigation. Although radiofrequency (RF)-tagged sponges have shown 100% sensitivity and specificity in general surgery, their performance in orthopedic procedures involving metallic implants remains underexplored. This study evaluates the reliability of RF-tagged sponges in total joint arthroplasty and identifies unique limitations associated with their use in orthopedic surgery. METHODS: A retrospective review was conducted of 2,251 total knee and total hip arthroplasty cases performed at a high-volume orthopedic center from April 30, 2024 to February 28, 2025. All cases employed both standard manual sponge counts and RF detection technology. The primary outcome was the discrepancy rate between manual and RF counts, with secondary analysis of false-positive and false-negative events and contributing intraoperative factors. RESULTS: Three discrepancies (0.13%) were identified. One case represented a false-negative RF scan in which the tag became undetectable due to cement polymerization and proximity to a metallic femoral stem. Two cases involved false-positive detections that resolved on repeat scanning without evidence of retained items. CONCLUSIONS: RF-tagged surgical sponges may serve as a useful adjunct for RFO prevention in orthopedic surgery but may be affected by metallic interference and tag damage during implant cementation. The technology should supplement, not replace, manual counts and intraoperative imaging. Further research is warranted to optimize RF performance in orthopedic applications. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When seconds matter - introducing a surgical salvage strategy by emergency robotic surgery: a review.","authors":"Ibrahim Büdeyri, Jan Philipp Ramspott, Mazen A Juratli, Andreas Pascher, Jens Peter Hoelzen","doi":"10.1186/s13037-026-00483-1","DOIUrl":"10.1186/s13037-026-00483-1","url":null,"abstract":"<p><p>Robotic surgery has expanded minimally invasive options but introduces specific vulnerabilities during intraoperative emergencies. The physical separation of the surgeon from the patient, restricted access due to docking, and dependence on complex technology can delay life‑saving interventions if teams are not prepared. This review summarizes current evidence and expert practice on emergency management along the perioperative pathway in robotic surgery, focusing on a structured, systems‑based salvage strategy. Key domains include preoperative planning, classification of recoverable and non‑recoverable errors, and standardized protocols for rapid undocking, conversion, hemorrhage control, and resuscitation. Particular emphasis is placed on human factors, including visible name tags, closed‑loop communication, and structured briefings to strengthen situational awareness and role clarity in crises. Simulation‑based curricula and high‑fidelity in situ drills are highlighted as essential for rehearsing rare but high‑impact events such as catastrophic bleeding, cardiorespiratory collapse, or robotic system failure. In parallel, technology‑driven tools such as surgeon‑controlled suction, advanced vessel sealing, and artificial‑intelligence-assisted monitoring are discussed as adjuncts for earlier recognition and standardized documentation of critical events. Integrating these elements into protocolized workflows can improve preparedness, shorten response times, and support safer decision‑making when seconds matter in robotic surgery.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identified practice gaps and opportunities in anesthesia safety across 14 Arab countries: a multicenter study.","authors":"Wael Sadaqa, Ahmad Abdulrahman Daqqa, Anas Hamdan, Ali Shawqi Saadoon, Abdelhaq Elmansori, Mehdi Trifa, Hesham Albabtain, Gunida Alguneid, Asim Osman, Maroun Ghabach, Abdullah Al-Naggar, Randah A Zaineldin, Ahmed Shahin, Abdulsatar Ravalia, Mohammad Safi, Khalil Abuarqub, Malik Alqub, Mohammad Masu'd","doi":"10.1186/s13037-026-00482-2","DOIUrl":"10.1186/s13037-026-00482-2","url":null,"abstract":"<p><p>BACKGROUND: Safe anesthesia is fundamental to safe surgery and depends on facility readiness, team behaviors, and consistent adherence to safety standards such as the World Health Organization (WHO) Surgical Safety Checklist. Across the Arab region, variability in workforce capacity, equipment and supplies, and checklist implementation may contribute to uneven safety performance, yet multicountry data describing readiness and routine anesthesia safety practices remain limited. We therefore assessed facility readiness and clinicians’ knowledge, attitudes, and self-reported safety practices, and examined how checklist use and perceived barriers relate to these domains across fourteen Arab countries. METHODS: We conducted a multicountry online cross-sectional survey of anesthesia team members working in hospital operating theatres and procedural anesthesia locations across fourteen Arab countries. The survey evaluated facility readiness, knowledge, attitudes, and self-reported safety practices, and captured frequency of surgical safety checklist use and perceived barriers to safe anesthesia practice. RESULTS: Overall, facility readiness and participants’ knowledge, attitudes, and self-reported safety practices were generally high; however, routine checklist use was not universal. Commonly reported barriers included understaffing and workload pressure, as well as financial constraints affecting equipment and supplies. More frequent checklist use was associated with better safety-related performance across assessed domains, whereas a higher barrier burden was associated with poorer readiness and self-reported practice. CONCLUSIONS: Although anesthesia safety performance was generally favorable across surveyed settings, important implementation and systems gaps remain, particularly in routine checklist use and resource-related constraints. Strengthening workforce capacity, ensuring access to essential equipment and supplies, and embedding meaningful, high-fidelity checklist use may help reduce residual safety gaps and support safer anesthesia care across diverse hospitals in the Arab region. TRIAL REGISTRATION: Not applicable. (This study is an observational cross-sectional survey and did not involve prospective assignment to a health-related intervention.) </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning prediction model for surgical site infections after major abdominal surgery.","authors":"Saif Ghabisha, Qasem Alyhari, Ahmed Ateik, Saleh Al-Wageeh, Faisal Ahmed, Mohammed Al-Shehari, Yasser Obadiel, Wadhah Hassan Edrees, Wadee Abdullah Al-Shehari","doi":"10.1186/s13037-026-00481-3","DOIUrl":"10.1186/s13037-026-00481-3","url":null,"abstract":"<p><p>BACKGROUND: Surgical site infections (SSIs) continue to exert a substantial burden on healthcare systems, particularly in resource-limited settings where they contribute to prolonged hospitalizations, escalated costs, and increased patient morbidity. The ability to accurately predict SSI risk is essential for implementing targeted prevention strategies and optimizing resource allocation, especially in constrained environments. METHODS: We conducted a retrospective cohort study utilizing data from 525 patients who underwent major gastrointestinal surgery at Al-Thora General Hospital, the sole Ibb University-affiliated tertiary hospital in Yemen, between January 2018 and December 2023. Four machine learning models (Logistic Regression, Random Forest, XGBoost, and Neural Network) were developed using 38 preoperative and intraoperative variables. Temporal validation was performed, with data from 2018 to 2022 used for model training (n = 420) and 2023 data (n = 105) reserved for testing. Model performance was evaluated by area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), calibration metrics, and decision curve analysis. Subgroup analyses assessed model fairness across demographic and clinical strata. RESULTS: The observed SSI rate was 16.2%, consistent across both training and test sets. XGBoost achieved the highest predictive performance (AUROC: 0.934; 95% CI: 0.891–0.967; AUPRC: 0.809), outperforming logistic regression (AUROC: 0.868, p = 0.012) and neural network (AUROC: 0.890, p = 0.038) models. Random Forest also demonstrated competitive accuracy (AUROC: 0.924; AUPRC: 0.787). Robust performance was maintained across critical subgroups, with XGBoost yielding an AUROC of 0.967 among elderly patients and Random Forest achieving an AUROC of 0.979 among diabetic patients. All models systematically overestimated SSI risk (calibration slopes > 2.0), though XGBoost exhibited the best calibration (Brier score: 0.080). Decision curve analysis confirmed clinical utility within probability thresholds of 15–35%. CONCLUSION: Machine learning models, specifically XGBoost and Random Forest, can accurately predict SSI risk following major gastrointestinal surgery in the Yemeni healthcare context. Despite calibration limitations, these models demonstrate strong discriminative ability and clinical utility, supporting their use for risk stratification in resource-limited settings. The development of a simplified risk score offers a pragmatic alternative for implementation in environments with limited technological infrastructure. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inadvertent guidewire retention after radial artery cannulation: report of two cases and safety lessons for vascular access practice.","authors":"Leopoldo Muniz da Silva, Rafael Souza Fava Nersessian, Saullo Queiroz Silveira, Helidea de Oliveira Lima, Glenio B Mizubuti","doi":"10.1186/s13037-026-00480-4","DOIUrl":"10.1186/s13037-026-00480-4","url":null,"abstract":"<p><p>BACKGROUND: Inadvertent guidewire retention is an uncommon but potentially serious complication most often described in the context of central venous catheterization, and reports involving arterial access are exceptionally rare. This report describes two cases of inadvertent guidewire retention following radial artery cannulation performed using the Seldinger technique for intraoperative hemodynamic monitoring. CASE PRESENTATION: In both cases, arterial cannulation was indicated because of complex (and possibly prolonged) surgical procedures with a risk of clinically significant blood loss, thereby necessitating continuous beat-to-beat arterial pressure monitoring. The presumed embolization mechanism involved advancement of the catheter while the pre-attached proximal cap remained in place, thereby preventing the guidewire from exiting proximally and ultimately leading to intravascular displacement of the wire. In the first case, the event remained unrecognized until the patient developed forearm pain, reduced radial and ulnar pulses, and sensory changes to the affected upper extremity several weeks postoperatively. Imaging revealed a retained guidewire extending from the radial artery to the axillary artery, requiring surgical intervention for retrieval. In the second case, the inadvertently retained guidewire was found incidentally on a routine chest radiograph eighteen days postoperatively. CONCLUSIONS: These cases illustrate that guidewire retention, albeit rare, can occur during arterial cannulation by the Seldinger technique and shares the same human-factor vulnerabilities long recognized in central venous access-related guidewire retention, including distraction, incomplete preparation and loss of wire control. In response, several system-level safety measures were implemented, including explicit “wire in hand” confirmation before catheter advancement, the use of wire length markers, mandatory removal of manufacturer attached catheter caps prior to insertion, optional sterile forceps control of the guidewire, multidisciplinary verification, and mandatory documentation of guidewire retrieval. These events reinforce the need for robust safety barriers across all procedures using the Seldinger technique to prevent guidewire retention and enhance procedural safety. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensive perinephric hematoma following excessive irrigation pressure during flexible ureteroscopy: case report of a preventable complication.","authors":"Chinnakhet Ketsuwan","doi":"10.1186/s13037-026-00479-x","DOIUrl":"10.1186/s13037-026-00479-x","url":null,"abstract":"<p><p>BACKGROUND: Flexible ureteroscopy (fURS) is widely regarded as a safe and effective procedure for the management of urolithiasis. Nevertheless, inadequate management of intrarenal pressure during fURS represents an underrecognized patient safety hazard. The use of high-pressure irrigation to compensate for poor visualization—particularly when outflow is restricted—may expose patients to prolonged supraphysiologic intrarenal pressure and preventable harm. I report a severe pressure-related renal injury following fURS and analyze the event using a human factors and systems-based root cause analysis framework. CASE PRESENTATION: A 45-year-old man underwent fURS for a 1.5-cm proximal ureteral stone. A ureteral access sheath was not used due to a tight distal ureter. During the 100-min procedure, visualization progressively deteriorated because of mucosal edema, bleeding, and debris. Irrigation was escalated using a manual pressure bag and reported intraoperatively as very high (300–400 mmHg on the pressure bag gauge) for a prolonged period. Shortly following surgery, the patient developed severe flank pain and a high-grade fever. Computed tomography revealed a massive perinephric hematoma without active contrast extravasation. The patient remained hemodynamically stable and improved with conservative management. CONCLUSION: The described event is best understood as a preventable iatrogenic injury arising from a predictable hazard: pressure escalation to restore visualization. It occurred in a system without adequate defenses, namely, limited outflow, a lack of real-time pressure feedback, the absence of pressure or time stop rules, and insufficient team cross-checks against cognitive fixation. Intrarenal pressure should be treated as a critical safety variable in endourology. Pressure-governed workflows—prioritizing outflow augmentation, objective monitoring when feasible, and escalation pathways that favor staging over unmonitored pressure escalation—are essential to prevent similar harm. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative hypoalbuminemia and surgical site infection in abdominal surgery: a systematic review and meta-analysis.","authors":"Hala Fathi EmamElkhir Omer, Maria Badraldin Ali Saga, Yaser Waheeb Slaiman Naser, Heba Mukhtar Abdalla Mukhtar, Tamney Ahmed Mohammed Hamed, Jawahir Osman Omer Ali, Noon Abdalla Mohamed, Tawasol Mustafa Abdalaty Mohamed, Hadeel Ahmed Ramadan Dawod, Ashraf Hassan Mohamed Hassan, Sagad O O Mohamed","doi":"10.1186/s13037-026-00478-y","DOIUrl":"10.1186/s13037-026-00478-y","url":null,"abstract":"<p><p>BACKGROUND: Surgical site infections (SSIs) represent a significant postoperative complication following gastrointestinal surgery. Hypoalbuminemia has been proposed as a potential risk factor, but the strength of this association remains unclear. This review aimed to systematically evaluate the relationship between preoperative serum albumin levels and SSI risk in patients undergoing gastrointestinal surgery. METHODS: A systematic search was conducted in PubMed, Web of Science, and Scopus from inception through November 2025. Studies were eligible if they examined the association between serum albumin and SSI in adult patients undergoing gastrointestinal surgery, measured preoperative serum albumin levels, and reported SSI as an outcome. Two separate analyses were performed: odds ratios (OR) comparing hypoalbuminemia versus normal albumin groups, and standardized mean differences (SMD) comparing albumin levels between patients with and without SSI. RESULTS: Twenty-three studies, involving 681,181 patients, were included. The meta-analysis demonstrated that hypoalbuminemia significantly increased SSI risk (OR 2.37, 95% CI: 1.84–3.05, p < 0.001). Analysis of studies comparing mean albumin levels showed patients with SSI had significantly lower albumin concentrations than those without SSI (SMD − 0.80, 95% CI: -1.21 to -0.39, p < 0.001). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected. CONCLUSION: Preoperative hypoalbuminemia is strongly associated with increased SSI risk following gastrointestinal surgery. From a clinical and patient safety perspective, serum albumin should be incorporated into preoperative risk stratification to identify high-risk patients and guide targeted interventions. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13072468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}