Department of Anaesthesia and Perfusion Services & Department of Surgery, The Prince Charles Hospital & University of Queensland, Rode Road, Chermside, Brisbane, QLD, Australia.
Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
J Gastrointest Surg. 2017 Oct;21(10):1700-1712. doi: 10.1007/s11605-017-3494-y. Epub 2017 Aug 7.
The aim of this meta-analysis is to comprehensively review and quantify the excess risk of surgical site infections (SSI) in obese patients following colorectal surgery.
A systematic electronic search of the MEDLINE and EMBASE databases identified studies that investigated the association of obesity, defined by body mass index (BMI) with SSI among colorectal surgery patients.
Twelve studies were included in the final analysis. Patients with BMI ≥30 kg/m were at 1.5 times (pooled OR 1.51, 95% CI: 1.39, 1.63, p < 0.001) higher odds of developing SSI after colorectal surgery when compared to BMI <30 kg/m. Subgroup analysis of the eight studies that investigated only elective procedures showed that the odds of developing SSI when BMI ≥30 kg/m is 1.6 times that of those with BMI <30 kg/m (pooled OR 1.60; 95% CI 1.34, 1.86; p < 0.001). The odds of having SSI when BMI is 25-29.9 kg/m are 1.2 times than those with BMI <25 kg/m (pooled OR 1.17; 95% CI 1.07, 1.28; p < 0.001).
Overweight and obese patients carry at least 20% and 50% higher odds of developing SSI after colorectal surgery compared to normal weight patients, respectively.
本荟萃分析旨在全面回顾和量化肥胖患者结直肠手术后手术部位感染(SSI)的风险增加。
系统地电子检索 MEDLINE 和 EMBASE 数据库,以确定研究肥胖与结直肠手术患者 SSI 之间关联的研究,肥胖定义为体重指数(BMI)。
最终分析纳入了 12 项研究。与 BMI <30 kg/m 的患者相比,BMI ≥30 kg/m 的患者在结直肠手术后发生 SSI 的几率高 1.5 倍(合并 OR 1.51,95%CI:1.39,1.63,p < 0.001)。对仅调查择期手术的 8 项研究进行的亚组分析表明,当 BMI ≥30 kg/m 时,发生 SSI 的几率是 BMI <30 kg/m 的 1.6 倍(合并 OR 1.60;95%CI 1.34,1.86;p < 0.001)。BMI 在 25-29.9 kg/m 时发生 SSI 的几率是 BMI <25 kg/m 的 1.2 倍(合并 OR 1.17;95%CI 1.07,1.28;p < 0.001)。
与体重正常的患者相比,超重和肥胖患者在结直肠手术后发生 SSI 的几率分别至少增加 20%和 50%。