Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis.
Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis.
复制标题
糖尿病和手术部位感染的风险：系统评价和荟萃分析。
DOI：
10.1017/ice.2015.249
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发表时间：
2016-01
影响因子：
4.5
通讯作者：
Jaber L
中科院分区：
文献类型：
--
作者：
Martin ET;Kaye KS;Knott C;Nguyen H;Santarossa M;Evans R;Bertran E;Jaber L
确定糖尿病与多种外科手术术后手术部位感染（SSI）之间的独立关联。
系统综述与荟萃分析
通过检索词“危险因素”或“葡萄糖”以及“手术部位感染”，确定了1985年12月至2015年7月期间在PubMed中收录的研究。最初的检索词共确定了3631篇摘要。对522篇文章进行了全文审查。其中，94篇文章符合纳入标准。使用标准化的数据收集表格来提取有关糖尿病、血糖水平和体重指数（BMI）的特定研究估计值。采用随机效应荟萃分析来生成汇总估计值，并使用荟萃回归来评估异质性的特定假设来源。
主要结局是按照美国疾病控制与预防中心监测标准定义的手术部位感染。糖尿病与手术部位感染之间关联的总体效应量为比值比（OR）=1.53（95%预测区间为1.11 - 2.12，I²：57.2%）。在荟萃回归模型中，手术部位感染类别、研究设计或患者体重指数对研究结果没有显著影响。与其他类型手术相比，心脏手术的关联更高，为2.03（95%预测区间为1.13 - 4.05）（p = 0.001）。
这些结果支持将糖尿病视为多种外科手术类型术后手术部位感染的独立危险因素。需要持续努力来改善糖尿病患者的手术结局。
To determine the independent association between diabetes and SSI across multiple surgical procedures. Systematic review and meta-analysis. Studies indexed in PubMed published between December 1985 and through July 2015 were identified through the search terms “risk factors” or “glucose” and “surgical site infection”. A total of 3,631 abstracts were identified through the initial search terms. Full texts were reviewed for 522 articles. Of these, 94 articles met the criteria for inclusion. Standardized data collection forms were used to extract study-specific estimates for diabetes, blood glucose levels, and body mass index (BMI). Random-effects meta-analysis was used to generate pooled estimates and meta-regression was used to evaluate specific hypothesized sources of heterogeneity. The primary outcome was SSI, as defined by the Centers for Disease Control and Prevention surveillance criteria. The overall effect size for the association between diabetes and SSI was OR=1.53 (95% Predictive Interval 1.11, 2.12, I2: 57.2%). SSI class, study design, or patient BMI did not significantly impact study results in a meta-regression model. The association was higher for cardiac surgery 2.03 (95% Predictive Interval 1.13, 4.05) compared to surgeries of other types (p=0.001). These results support the consideration of diabetes as an independent risk factor for SSIs for multiple surgical procedure types. Continued efforts are needed to improve surgical outcomes for diabetic patients.