Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis
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REVIEW
Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis Zhaohui Xu 1 & Hui Qu 1 & George Kanani 1 & Zhong Guo 1 & Yanying Ren 2 & Xin Chen 2 Accepted: 20 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Surgical site infection (SSI) in colorectal cancer (CRC) has been a serious health care problem due to the delay of postoperative recovery. Our present study aimed to explore the risk factors for SSI in CRC patients. Methodology We have systematically searched these databases: PubMed, Cochrane Library, and EMBASE as of March 2020 for studies on risk factors associated with SSI. Two investigators independently conducted the quality assessment and data extraction. Related risk factors in the studies were recorded, and a meta-analysis was performed. Results The search initially provided 2262 hits, 1913 studies were screened by two independent investigators. Finally, 15 studies were identified to be relevant for this meta-analysis. In total, 25 risk factors were eligible. Our meta-analysis indicated that eight factors (obesity, male sex, diabetes mellitus, ASA score ≥ 3, stoma creation, intraoperative complications, perioperative blood transfusion, and operation time ≥ 180 min) were significant risk factors for SSI, and one factor (laparoscopic procedure) was protective for SSI. Conclusions Effective interventions targeting the above factors may reduce the risk of developing postoperative SSI in CRC patients and improve the clinical outcome of patients. Further prospective studies are needed to confirm these findings. Keywords Colorectal cancer . Surgical wound infection . Risk factors . Systematic review
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03706-8) contains supplementary material, which is available to authorized users. * Xin Chen [email protected] Zhaohui Xu [email protected] Hui Qu [email protected] George Kanani [email protected] Zhong Guo [email protected] Yanying Ren [email protected] 1
Dalian Medical University, Dalian, China
2
Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian 116023, People’s Republic of China
Surgical site infection (SSI) is defined as any infection developing within 30 days after the operation or within 1 year if implant is in place [1], accounting for 30–40% of all complications [2]. It is a serious public health concern affecting approximately 500,000 people each year in the United States [3]. Poor clinical outcomes with SSI include prolonged hospital stay, delayed rehabilitation, long-term disability, and increased treatment costs [4–6]. For example, study says that patients with SSI spend excess healthcare expenditures annually ($3.5 billion–$10 billion), driven primarily by approximately an increase of 7–10 additional postoperative hospital days [7]. Colorectal cancer (CRC) has a high risk of morbidity (10– 40%) and mortality (0
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