Yu Zhang1, Qiu-Jian Zheng2, Sheng Wang3, Shi-Xing Zeng2, You-Ping Zhang1, Xue-Jiao Bai1, Tie-Ying Hou4. 1. Department of Hospital Acquired Infection Control, Guangdong Academy of Medicine Science and Guangdong General Hospital, Guangzhou, China. 2. Department of Orthopaedics, Guangdong Academy of Medicine Science and Guangdong General Hospital, Guangzhou, China. 3. Department of Anaesthesiology, Guangdong Academy of Medicine Science and Guangdong General Hospital, Guangzhou, China. 4. Department of Hospital Acquired Infection Control, Guangdong Academy of Medicine Science and Guangdong General Hospital, Guangzhou, China. Electronic address: 670293234@qq.com.
Abstract
BACKGROUND AND OBJECTIVE: Observational studies have suggested an association between diabetes mellitus and the risk of surgical site infections (SSIs), but the results remain inconclusive. We conducted a meta-analysis of prospective cohort studies to elucidate the relationship between diabetes mellitus and SSIs. METHODS: We searched PubMed, Embase, and Web of Science databases and reviewed the reference lists of the retrieved articles to identify relevant studies. Associations were tested in subgroups representing different patient characteristics and study quality criteria. The random-effect model was used to calculate the overall relative risk (RR). RESULTS: Fourteen prospective cohort studies (N = 91,094 participants) were included in this meta-analysis, and the pooled crude RR was 2.02 (95% confidence interval, 1.68-2.43) with significant between-study heterogeneity observed (I(2) = 56.50%). Significant association was also detected after we derived adjusted RRs for studies not reporting the adjusted RRs and calculated the combined adjusted RR of the 14 studies (RR, 1.69; 95% confidence interval, 1.33-2.13). Results were consistent and statistically significant in all subgroups. Stratified analyses found the number of confounders adjusted for, sample size, and method of diabetes case ascertainment might be the potential sources of heterogeneity. Sensitivity analysis further demonstrated the robustness of the result. CONCLUSIONS: This meta-analysis suggests diabetes mellitus is significantly associated with increased risk of SSIs. Future studies are encouraged to reveal the mechanisms underlying this association.
BACKGROUND AND OBJECTIVE: Observational studies have suggested an association between diabetes mellitus and the risk of surgical site infections (SSIs), but the results remain inconclusive. We conducted a meta-analysis of prospective cohort studies to elucidate the relationship between diabetes mellitus and SSIs. METHODS: We searched PubMed, Embase, and Web of Science databases and reviewed the reference lists of the retrieved articles to identify relevant studies. Associations were tested in subgroups representing different patient characteristics and study quality criteria. The random-effect model was used to calculate the overall relative risk (RR). RESULTS: Fourteen prospective cohort studies (N = 91,094 participants) were included in this meta-analysis, and the pooled crude RR was 2.02 (95% confidence interval, 1.68-2.43) with significant between-study heterogeneity observed (I(2) = 56.50%). Significant association was also detected after we derived adjusted RRs for studies not reporting the adjusted RRs and calculated the combined adjusted RR of the 14 studies (RR, 1.69; 95% confidence interval, 1.33-2.13). Results were consistent and statistically significant in all subgroups. Stratified analyses found the number of confounders adjusted for, sample size, and method of diabetes case ascertainment might be the potential sources of heterogeneity. Sensitivity analysis further demonstrated the robustness of the result. CONCLUSIONS: This meta-analysis suggests diabetes mellitus is significantly associated with increased risk of SSIs. Future studies are encouraged to reveal the mechanisms underlying this association.
Authors: Peter Fasching; Joakim Huber; Martin Clodi; Heidemarie Abrahamian; Bernhard Ludvik Journal: Wien Klin Wochenschr Date: 2016-04 Impact factor: 1.704
Authors: Stephanie Ostling; Jennifer Wyckoff; Scott L Ciarkowski; Chih-Wen Pai; Hae Mi Choe; Vinita Bahl; Roma Gianchandani Journal: Clin Diabetes Endocrinol Date: 2017-03-22
Authors: Winward Choy; Nikki Barrington; Roxanna M Garcia; Robert B Kim; Heron Rodriguez; Sandi Lam; Nader Dahdaleh; Zachary A Smith Journal: Global Spine J Date: 2017-04-06
Authors: Su Yu Tang; Shun Wen Zhang; Jiang Dong Wu; Fang Wu; Jie Zhang; Jiang Tao Dong; Peng Guo; Da Long Zhang; Jun Ting Yang; Wan Jiang Zhang Journal: Exp Ther Med Date: 2018-01-09 Impact factor: 2.447