A systematic review of risk factors associated with surgical site infections among surgical patients.

<h4>Importance</h4>Surgical site infection (SSI) complicates 2-5% of surgeries in the United States. Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis, and SSIs are responsible for increased morbidity, mortality, and economic burd...

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Autores principales:	Ellen Korol, Karissa Johnston, Nathalie Waser, Frangiscos Sifakis, Hasan S Jafri, Mathew Lo, Moe H Kyaw
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/38a71aea14454d478251a92bd53fcad0
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spelling	oai:doaj.org-article:38a71aea14454d478251a92bd53fcad02021-11-18T08:41:16ZA systematic review of risk factors associated with surgical site infections among surgical patients.1932-620310.1371/journal.pone.0083743https://doaj.org/article/38a71aea14454d478251a92bd53fcad02013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24367612/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Importance</h4>Surgical site infection (SSI) complicates 2-5% of surgeries in the United States. Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis, and SSIs are responsible for increased morbidity, mortality, and economic burden associated with surgery. Staphylococcus aureus (S. aureus) is a commonly-isolated organism for SSI, and methicillin-resistant S. aureus SSI incidence is increasing globally.<h4>Objective</h4>The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting.<h4>Evidence review</h4>An initial search identified 328 titles published in 2002-2012; 57 were identified as relevant for data extraction. Extracted information included study design and methodology, reported cumulative incidence and post-surgical time until onset of SSI, and odds ratios and associated variability for all factors considered in univariate and/or multivariable analyses.<h4>Findings</h4>Median SSI incidence was 3.7%, ranging from 0.1% to 50.4%. Incidence of overall SSI and S. aureus SSI were both highest in tumor-related and transplant surgeries. Median time until SSI onset was 17.0 days, with longer time-to-onset for orthopedic and transplant surgeries. Risk factors consistently identified as associated with SSI included co-morbidities, advanced age, risk indices, patient frailty, and surgery complexity. Thirteen studies considered diabetes as a risk factor in multivariable analysis; 85% found a significant association with SSI, with odds ratios ranging from 1.5-24.3. Longer surgeries were associated with increased SSI risk, with a median odds ratio of 2.3 across 11 studies reporting significant results.<h4>Conclusions and relevance</h4>In a broad review of published literature, risk factors for SSI were characterized as describing reduced fitness, patient frailty, surgery duration, and complexity. Recognition of risk factors frequently associated with SSI allows for identification of such patients with the greatest need for optimal preventive measures to be identified and pre-treatment prior to surgery.Ellen KorolKarissa JohnstonNathalie WaserFrangiscos SifakisHasan S JafriMathew LoMoe H KyawPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e83743 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ellen Korol Karissa Johnston Nathalie Waser Frangiscos Sifakis Hasan S Jafri Mathew Lo Moe H Kyaw A systematic review of risk factors associated with surgical site infections among surgical patients.
description	<h4>Importance</h4>Surgical site infection (SSI) complicates 2-5% of surgeries in the United States. Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis, and SSIs are responsible for increased morbidity, mortality, and economic burden associated with surgery. Staphylococcus aureus (S. aureus) is a commonly-isolated organism for SSI, and methicillin-resistant S. aureus SSI incidence is increasing globally.<h4>Objective</h4>The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting.<h4>Evidence review</h4>An initial search identified 328 titles published in 2002-2012; 57 were identified as relevant for data extraction. Extracted information included study design and methodology, reported cumulative incidence and post-surgical time until onset of SSI, and odds ratios and associated variability for all factors considered in univariate and/or multivariable analyses.<h4>Findings</h4>Median SSI incidence was 3.7%, ranging from 0.1% to 50.4%. Incidence of overall SSI and S. aureus SSI were both highest in tumor-related and transplant surgeries. Median time until SSI onset was 17.0 days, with longer time-to-onset for orthopedic and transplant surgeries. Risk factors consistently identified as associated with SSI included co-morbidities, advanced age, risk indices, patient frailty, and surgery complexity. Thirteen studies considered diabetes as a risk factor in multivariable analysis; 85% found a significant association with SSI, with odds ratios ranging from 1.5-24.3. Longer surgeries were associated with increased SSI risk, with a median odds ratio of 2.3 across 11 studies reporting significant results.<h4>Conclusions and relevance</h4>In a broad review of published literature, risk factors for SSI were characterized as describing reduced fitness, patient frailty, surgery duration, and complexity. Recognition of risk factors frequently associated with SSI allows for identification of such patients with the greatest need for optimal preventive measures to be identified and pre-treatment prior to surgery.
format	article
author	Ellen Korol Karissa Johnston Nathalie Waser Frangiscos Sifakis Hasan S Jafri Mathew Lo Moe H Kyaw
author_facet	Ellen Korol Karissa Johnston Nathalie Waser Frangiscos Sifakis Hasan S Jafri Mathew Lo Moe H Kyaw
author_sort	Ellen Korol
title	A systematic review of risk factors associated with surgical site infections among surgical patients.
title_short	A systematic review of risk factors associated with surgical site infections among surgical patients.
title_full	A systematic review of risk factors associated with surgical site infections among surgical patients.
title_fullStr	A systematic review of risk factors associated with surgical site infections among surgical patients.
title_full_unstemmed	A systematic review of risk factors associated with surgical site infections among surgical patients.
title_sort	systematic review of risk factors associated with surgical site infections among surgical patients.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/38a71aea14454d478251a92bd53fcad0
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A systematic review of risk factors associated with surgical site infections among surgical patients.

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