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合并症对急诊手术患者手术部位感染发生率的影响:一项系统评价和荟萃分析

Effect of Comorbidities on the Incidence of Surgical Site Infection in Patients Undergoing Emergency Surgery: A Systematic Review and Meta-Analysis.

作者信息

Amirah Asriwati, Harahap Juliandi, Willim Herick Alvenus, Suroyo Razia Begum, Henderson Alhoi Hendry

机构信息

Faculty of Public Health, Institut Kesehatan Helvetia, Medan, Indonesia.

Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

J Clin Med Res. 2024 Aug;16(7-8):345-354. doi: 10.14740/jocmr5222. Epub 2024 Aug 12.

Abstract

BACKGROUND

Surgical site infection (SSI) is a significant concern in patients undergoing emergency surgery, particularly in those with underlying comorbidities. This meta-analysis aimed to evaluate the effect of comorbidities, including diabetes mellitus, hypertension, obesity, pulmonary disease, cardiac disease, liver disease, and renal disease, on the incidence of SSI in patients undergoing emergency surgery.

METHODS

We performed a systematic literature search across electronic databases including PubMed, ScienceDirect, Cochrane Library, ProQuest, and Google Scholar to identify studies examining the effect of comorbidities on the incidence of SSI in patients undergoing emergency surgery. To determine the effect size, pooled odds ratios (ORs) were calculated. Statistical analysis was performed using Review Manager 5.3 software.

RESULTS

Thirteen studies involving 8,952 patients undergoing emergency surgery were included in this meta-analysis. The pooled analysis showed that the following comorbidities significantly increased the risk of SSI following emergency surgery: diabetes mellitus (OR = 2.22; 95% confidence interval (CI) = 1.52 - 3.25; P < 0.0001), obesity (OR = 1.43; 95% CI = 1.19 - 1.72; P = 0.0001), and liver disease (OR = 1.66; 95% CI = 1.37 - 2.00; P < 0.00001). However, hypertension, pulmonary disease, cardiac disease, and renal disease showed no significant association with SSI.

CONCLUSIONS

In patients undergoing emergency surgery, the presence of comorbidities including diabetes mellitus, obesity, and liver disease increases the incidence of developing SSI.

摘要

背景

手术部位感染(SSI)是急诊手术患者的一个重大问题,尤其是那些有基础合并症的患者。本荟萃分析旨在评估合并症,包括糖尿病、高血压、肥胖、肺部疾病、心脏病、肝病和肾病,对急诊手术患者SSI发生率的影响。

方法

我们在包括PubMed、ScienceDirect、Cochrane图书馆、ProQuest和谷歌学术在内的电子数据库中进行了系统的文献检索,以确定研究合并症对急诊手术患者SSI发生率影响的研究。为了确定效应大小,计算了合并比值比(OR)。使用Review Manager 5.3软件进行统计分析。

结果

本荟萃分析纳入了13项涉及8952例急诊手术患者的研究。汇总分析表明,以下合并症显著增加了急诊手术后SSI的风险:糖尿病(OR = 2.22;95%置信区间(CI)= 1.52 - 3.25;P < 0.0001)、肥胖(OR = 1.43;95%CI = 1.19 - 1.72;P = 0.0001)和肝病(OR = 1.66;95%CI = 1.37 - 2.00;P < 0.00001)。然而,高血压、肺部疾病、心脏病和肾病与SSI无显著关联。

结论

在急诊手术患者中,包括糖尿病、肥胖和肝病在内的合并症会增加发生SSI的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8e/11349128/7fc814036094/jocmr-16-345-g001.jpg

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