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Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis.
Tsantes, A G; Papadopoulos, D V; Lytras, T; Tsantes, A E; Mavrogenis, A F; Koulouvaris, P; Gelalis, I D; Ploumis, A; Korompilias, A V; Benzakour, T; Tsivgoulis, G; Bonovas, S.
Afiliación
  • Tsantes AG; First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece; World Association Against Infection in Orthopaedics and Trauma Study Group, Milan, Italy. Electronic address: andreas.tsantes@yahoo.com.
  • Papadopoulos DV; Department of Orthopaedics, University of Ioannina, School of Medicine, University Hospital of Ioannina, Ioannina, Greece.
  • Lytras T; Hellenic Centre for Disease Control and Prevention, Athens, Greece.
  • Tsantes AE; Laboratory of Haematology and Blood Bank Unit, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.
  • Mavrogenis AF; First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece; World Association Against Infection in Orthopaedics and Trauma Study Group, Milan, Italy.
  • Koulouvaris P; First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.
  • Gelalis ID; Department of Orthopaedics, University of Ioannina, School of Medicine, University Hospital of Ioannina, Ioannina, Greece.
  • Ploumis A; Department of Physical Medicine and Rehabilitation, University of Ioannina, Ioannina, Greece.
  • Korompilias AV; Department of Orthopaedics, University of Ioannina, School of Medicine, University Hospital of Ioannina, Ioannina, Greece.
  • Benzakour T; World Association Against Infection in Orthopaedics and Trauma Study Group, Milan, Italy; Zerktouni Orthopaedic Clinic, Casablanca, Morocco.
  • Tsivgoulis G; Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece; Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
  • Bonovas S; Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Clinical and Research Centre, Milan, Italy.
J Hosp Infect ; 104(1): 111-119, 2020 Jan.
Article en En | MEDLINE | ID: mdl-31562915
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Columna Vertebral / Infección de la Herida Quirúrgica / Procedimientos Neuroquirúrgicos / Desnutrición Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Aspecto: Determinantes_sociais_saude Límite: Female / Humans / Male Idioma: En Revista: J Hosp Infect Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Columna Vertebral / Infección de la Herida Quirúrgica / Procedimientos Neuroquirúrgicos / Desnutrición Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Aspecto: Determinantes_sociais_saude Límite: Female / Humans / Male Idioma: En Revista: J Hosp Infect Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido