NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, England, United Kingdom.
Health Economics Unit, Institute of Applied Health, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom.
PLoS One. 2020 Jun 4;15(6):e0232960. doi: 10.1371/journal.pone.0232960. eCollection 2020.
Surgical site infection (SSI) is a worldwide problem which has morbidity, mortality and financial consequences. The incidence rate of SSI is high in Low- and Middle-Income countries (LMICs) compared to high income countries, and the costly surgical complication can raise the potential risk of financial catastrophe.
The aim of the study is to critically appraise studies on the cost of SSI in a range of LMIC studies and compare these estimates with a reference standard of high income European studies who have explored similar SSI costs.
A systematic review was undertaken using searches of two electronic databases, EMBASE and MEDLINE In-Process & Other Non-Indexed Citations, up to February 2019. Study characteristics, comparator group, methods and results were extracted by using a standard template.
Studies from 15 LMIC and 16 European countries were identified and reviewed in full. The additional cost of SSI range (presented in 2017 international dollars) was similar in the LMIC ($174-$29,610) and European countries ($21-$34,000). Huge study design heterogeneity was encountered across the two settings.
SSIs were revealed to have a significant cost burden in both LMICs and High Income Countries in Europe. The magnitude of the costs depends on the SSI definition used, severity of SSI, patient population, choice of comparator, hospital setting, and cost items included. Differences in study design affected the comparability across studies. There is need for multicentre studies with standardized data collection methods to capture relevant costs and consequences of the infection across income settings.
手术部位感染（SSI）是一个全球性问题，会导致发病率、死亡率和经济后果。与高收入国家相比，中低收入国家（LMICs）的 SSI 发生率较高，这种代价高昂的手术并发症可能会带来潜在的财务灾难风险。
本研究旨在批判性地评估一系列 LMIC 研究中 SSI 成本的研究，并将这些估计与探索类似 SSI 成本的高收入欧洲研究的参考标准进行比较。
使用两个电子数据库 EMBASE 和 MEDLINE In-Process & Other Non-Indexed Citations 进行了系统评价，检索截至 2019 年 2 月。使用标准模板提取研究特征、对照组、方法和结果。
确定并全面审查了来自 15 个 LMIC 和 16 个欧洲国家的研究。SSI 的额外成本范围（以 2017 年国际美元表示）在 LMIC（$174-$29,610）和欧洲国家（$21-$34,000）中相似。在这两种情况下都遇到了巨大的研究设计异质性。
SSI 在中低收入国家和欧洲高收入国家都存在重大的经济负担。成本的大小取决于使用的 SSI 定义、SSI 的严重程度、患者人群、对照选择、医院环境以及包括的成本项目。研究设计的差异影响了研究之间的可比性。需要进行多中心研究，采用标准化的数据收集方法，以在不同收入环境中捕捉感染的相关成本和后果。
