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Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis.

Identifieur interne : 000610 ( Main/Exploration ); précédent : 000609; suivant : 000611

Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis.

Auteurs : A G Tsantes [Italie] ; D V Papadopoulos [Grèce] ; T. Lytras [Grèce] ; A E Tsantes [Grèce] ; A F Mavrogenis [Italie] ; P. Koulouvaris [Grèce] ; I D Gelalis [Grèce] ; A. Ploumis [Grèce] ; A V Korompilias [Grèce] ; T. Benzakour [Maroc] ; G. Tsivgoulis [États-Unis] ; S. Bonovas [Italie]

Source :

The Journal of hospital infection [ 1532-2939 ] ; 2020.

RBID : pubmed:31562915

Descripteurs français

KwdFr :
- Complications postopératoires (microbiologie), Complications postopératoires (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Infection de plaie opératoire (microbiologie), Infection de plaie opératoire (épidémiologie), Malnutrition (complications), Mâle (MeSH), Procédures de neurochirurgie (effets indésirables), Rachis (chirurgie), Études cas-témoins (MeSH), Études rétrospectives (MeSH).
MESH :
- chirurgie : Rachis.
- effets indésirables : Malnutrition, Procédures de neurochirurgie.
- microbiologie : Complications postopératoires, Infection de plaie opératoire.
- épidémiologie : Complications postopératoires, Infection de plaie opératoire.
- Facteurs de risque, Femelle, Humains, Mâle, Études cas-témoins, Études rétrospectives.

English descriptors

KwdEn :
- Case-Control Studies (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Malnutrition (complications), Neurosurgical Procedures (adverse effects), Postoperative Complications (epidemiology), Postoperative Complications (microbiology), Retrospective Studies (MeSH), Risk Factors (MeSH), Spine (surgery), Surgical Wound Infection (epidemiology), Surgical Wound Infection (microbiology).
MESH :
- adverse effects : Neurosurgical Procedures.
- complications : Malnutrition.
- epidemiology : Postoperative Complications, Surgical Wound Infection.
- microbiology : Postoperative Complications, Surgical Wound Infection.
- surgery : Spine.
- Case-Control Studies, Female, Humans, Male, Retrospective Studies, Risk Factors.

Abstract

BACKGROUND

Surgical site infection (SSI) following spinal surgery is a frequent clinical problem with significant clinical and socio-economic consequences. Malnutrition has been linked with SSI in various other surgical procedures.

AIM

To investigate whether malnutrition is a risk factor for SSI following spinal surgery.

METHODS

Two electronic databases (PUBMED and SCOPUS) and the Cochrane Library were searched systematically from inception to May 2019. Cohort and case-control studies assessing malnutrition as a risk factor for SSI in patients undergoing spinal procedures were considered eligible. Μalnutrition was defined according to laboratory measurements or by relevant International Classification of Diseases-9 codes. SSI was the outcome of interest. Two reviewers independently abstracted study data and assessed the risk of bias for each study. Pooled effect estimates were calculated using random effects models.

FINDINGS

In total, 22 studies (20 retrospective cohort and two case-control) with over 175,000 participants (of whom 2.14% developed postoperative SSI) were analysed. SSIs were more likely to develop in malnourished patients [odds ratio (OR) 2.31, 95% confidence interval (CI) 1.75-3.05]. While pre-operative malnutrition was significantly associated with SSI in patients undergoing thoracolumbar spinal and sacral surgery, no significant difference was seen in patients undergoing cervical spinal surgery. In subgroup analyses, similar results were observed for both hospital-based (OR 3.16, 95% CI 1.84-5.43) and population-based (OR 2.00, 95% CI 1.63-2.46) studies.

CONCLUSIONS

Malnutrition is associated with increased risk of developing SSI after spinal surgery. Further high-quality research is warranted to investigate whether improvement of pre-operative nutritional status can decrease SSI rates.

DOI: 10.1016/j.jhin.2019.09.015
PubMed: 31562915

Affiliations:

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Case-Control Studies (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Malnutrition (complications)</term>
<term>Neurosurgical Procedures (adverse effects)</term>
<term>Postoperative Complications (epidemiology)</term>
<term>Postoperative Complications (microbiology)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Risk Factors (MeSH)</term>
<term>Spine (surgery)</term>
<term>Surgical Wound Infection (epidemiology)</term>
<term>Surgical Wound Infection (microbiology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Complications postopératoires (microbiologie)</term>
<term>Complications postopératoires (épidémiologie)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infection de plaie opératoire (microbiologie)</term>
<term>Infection de plaie opératoire (épidémiologie)</term>
<term>Malnutrition (complications)</term>
<term>Mâle (MeSH)</term>
<term>Procédures de neurochirurgie (effets indésirables)</term>
<term>Rachis (chirurgie)</term>
<term>Études cas-témoins (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Neurosurgical Procedures</term>
</keywords>
<keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Rachis</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Malnutrition</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Malnutrition</term>
<term>Procédures de neurochirurgie</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Postoperative Complications</term>
<term>Surgical Wound Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Complications postopératoires</term>
<term>Infection de plaie opératoire</term>
</keywords>
<keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Postoperative Complications</term>
<term>Surgical Wound Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Spine</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term>
<term>Infection de plaie opératoire</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Case-Control Studies</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Retrospective Studies</term>
<term>Risk Factors</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Études cas-témoins</term>
<term>Études rétrospectives</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Surgical site infection (SSI) following spinal surgery is a frequent clinical problem with significant clinical and socio-economic consequences. Malnutrition has been linked with SSI in various other surgical procedures.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>AIM</b>
</p>
<p>To investigate whether malnutrition is a risk factor for SSI following spinal surgery.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Two electronic databases (PUBMED and SCOPUS) and the Cochrane Library were searched systematically from inception to May 2019. Cohort and case-control studies assessing malnutrition as a risk factor for SSI in patients undergoing spinal procedures were considered eligible. Μalnutrition was defined according to laboratory measurements or by relevant International Classification of Diseases-9 codes. SSI was the outcome of interest. Two reviewers independently abstracted study data and assessed the risk of bias for each study. Pooled effect estimates were calculated using random effects models.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>FINDINGS</b>
</p>
<p>In total, 22 studies (20 retrospective cohort and two case-control) with over 175,000 participants (of whom 2.14% developed postoperative SSI) were analysed. SSIs were more likely to develop in malnourished patients [odds ratio (OR) 2.31, 95% confidence interval (CI) 1.75-3.05]. While pre-operative malnutrition was significantly associated with SSI in patients undergoing thoracolumbar spinal and sacral surgery, no significant difference was seen in patients undergoing cervical spinal surgery. In subgroup analyses, similar results were observed for both hospital-based (OR 3.16, 95% CI 1.84-5.43) and population-based (OR 2.00, 95% CI 1.63-2.46) studies.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Malnutrition is associated with increased risk of developing SSI after spinal surgery. Further high-quality research is warranted to investigate whether improvement of pre-operative nutritional status can decrease SSI rates.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Grèce</li>
<li>Italie</li>
<li>Maroc</li>
<li>États-Unis</li>
</country>
<region><li>Attique (région)</li>
<li>Lombardie</li>
<li>Tennessee</li>
</region>
<settlement><li>Athènes</li>
<li>Milan</li>
</settlement>
</list>
<tree><country name="Italie"><region name="Lombardie"><name sortKey="Tsantes, A G" sort="Tsantes, A G" uniqKey="Tsantes A" first="A G" last="Tsantes">A G Tsantes</name>
</region>
<name sortKey="Bonovas, S" sort="Bonovas, S" uniqKey="Bonovas S" first="S" last="Bonovas">S. Bonovas</name>
<name sortKey="Mavrogenis, A F" sort="Mavrogenis, A F" uniqKey="Mavrogenis A" first="A F" last="Mavrogenis">A F Mavrogenis</name>
</country>
<country name="Grèce"><noRegion><name sortKey="Papadopoulos, D V" sort="Papadopoulos, D V" uniqKey="Papadopoulos D" first="D V" last="Papadopoulos">D V Papadopoulos</name>
</noRegion>
<name sortKey="Gelalis, I D" sort="Gelalis, I D" uniqKey="Gelalis I" first="I D" last="Gelalis">I D Gelalis</name>
<name sortKey="Korompilias, A V" sort="Korompilias, A V" uniqKey="Korompilias A" first="A V" last="Korompilias">A V Korompilias</name>
<name sortKey="Koulouvaris, P" sort="Koulouvaris, P" uniqKey="Koulouvaris P" first="P" last="Koulouvaris">P. Koulouvaris</name>
<name sortKey="Lytras, T" sort="Lytras, T" uniqKey="Lytras T" first="T" last="Lytras">T. Lytras</name>
<name sortKey="Ploumis, A" sort="Ploumis, A" uniqKey="Ploumis A" first="A" last="Ploumis">A. Ploumis</name>
<name sortKey="Tsantes, A E" sort="Tsantes, A E" uniqKey="Tsantes A" first="A E" last="Tsantes">A E Tsantes</name>
</country>
<country name="Maroc"><noRegion><name sortKey="Benzakour, T" sort="Benzakour, T" uniqKey="Benzakour T" first="T" last="Benzakour">T. Benzakour</name>
</noRegion>
</country>
<country name="États-Unis"><region name="Tennessee"><name sortKey="Tsivgoulis, G" sort="Tsivgoulis, G" uniqKey="Tsivgoulis G" first="G" last="Tsivgoulis">G. Tsivgoulis</name>
</region>
</country>
</tree>
</affiliations>
</record>

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Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis.

Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis.

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