Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 16, Number 7-8, August 2024, pages 345-354

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

Figures

Figure 1.
Figure 1. Literature search flow chart.
Figure 2.
Figure 2. Forest plot of meta-analysis on the effect of diabetes mellitus on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 3.
Figure 3. Forest plot of meta-analysis on the effect of hypertension on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 4.
Figure 4. Forest plot of meta-analysis on the effect of obesity on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 5.
Figure 5. Forest plot of meta-analysis on the effect of pulmonary disease on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 6.
Figure 6. Forest plot of meta-analysis on the effect of cardiac disease on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 7.
Figure 7. Forest plot of meta-analysis on the effect of liver disease on SSI. CI: confidence interval; SSI: surgical site infection.
Figure 8.
Figure 8. Forest plot of meta-analysis on the effect of renal disease on SSI. SSI: surgical site infection.

Tables

Table 1. Characteristics of the Included Studies in the Meta-Analysis
 
First author, yearCountryDesignPatients’ characteristicsSample sizeMean age (years)Male, n (%)Incidence of SSI, n (%)
PC: prospective cohort; RC: retrospective cohort; SSI: surgical site infection; NR: not reported.
El-Kholy et al, 2018 [15]EgyptPCPatients underwent emergency general surgery994367 (68)33 (6.7)
Fernandez-Moure et al, 2021 [16]USARCPatients underwent emergency exploratory laparotomy4,73850NR632 (15.2)
Isbell et al, 2021 [17]USARCPatients underwent emergency trauma laparotomy1,322331,032 (78)88 (7)
Khan et al, 2022 [18]BangladeshPCPatients underwent emergency abdominal surgery1123785 (76)17 (15.2)
Li et al, 2021 [19]ChinaPCPatients underwent emergency abdominal surgery95349534 (56)71 (7.5)
Mathew et al, 2015 [20]IndiaPCPatients underwent emergency general surgery1323597 (73)33 (25)
Narueponjirakul et al, 2021 [21]USARCPatients underwent emergency colon surgery23667101 (43)61 (25.8)
Pandey et al, 2016 [22]IndiaPCPatients underwent emergency general surgery1084681 (75)18 (16.7)
Papadopoulos et al, 2021 [23]GreecePCPatients underwent emergency general surgery83851470 (56)157 (18.7)
Watanabe et al, 2014 [24]JapanRCPatients underwent emergency colorectal surgery786145 (58)25 (32.1)
Yang et al, 2015 [25]ChinaRCPatients underwent emergency hernia surgery12168100 (83)9 (7.4)
Feng et al, 2022 [26]ChinaRCPatients underwent emergency ileus surgery1256267 (54)37 (29.6)
Yadav et al, 2023 [27]NepalPCPatients underwent emergency abdominal surgery904362 (69)29 (32.2)

 

Table 2. Quality Assessment of the Included Studies by Newcastle-Ottawa Scale
 
First author, yearSelectionComparabilityOutcomeTotal score
El-Kholy et al, 2018 [15]3227
Fernandez-Moure et al, 2021 [16]4239
Isbell et al, 2021 [17]4239
Khan et al, 2022 [18]4239
Li et al, 2021 [19]4239
Mathew et al, 2015 [20]4228
Narueponjirakul et al, 2021 [21]3238
Pandey et al, 2016 [22]3227
Papadopoulos et al, 2021 [23]4239
Watanabe et al, 2014 [24]4239
Yang et al, 2015 [25]3238
Feng et al, 2022 [26]4239
Yadav et al, 2023 [27]4228

 

Table 3. Meta-Analysis of the Effect of Comorbidities on SSI in Patients Undergoing Emergency Surgery
 
Risk factorStudiesI2 (%)OR95% CIP value
SSI: surgical site infection; OR: odds ratio; CI: confidence interval.
Diabetes mellitus11672.221.52 - 3.25< 0.0001
Hypertension4620.950.62 - 1.470.82
Obesity5471.431.19 - 1.720.0001
Pulmonary disease4641.390.83 - 2.320.21
Cardiac disease4611.350.90 - 2.010.14
Liver disease301.661.37 - 2.00< 0.00001
Renal disease401.040.85 - 1.280.67