Meta-analysis of risk factors of surgical site infection in Chinese patients with spinal surgery

English Keywords:Surgical site infection  Spinal surgery  Risk factors  Meta-analysis

English Abstract:

  【Abstracts】 Objectives: To comprehensively evaluate the risk factors of surgical site infection after spinal surgery, and to provide science basis for the management of surgical site infection in patients with spinal surgery. Methods: Electronic databases including PubMed(1966.1-2017.5), EMBASE(1974.1-2017.5), Cochrane Library(2017.5), CNKI(1994.1-2017.5), CBM(1979.1-2017.5), VIP(1989.1-2017.5) and Wanfang(1982.1-2017.5) were searched to identity studies that assessed the risk factors of surgical site infection in Chinese patients up to May 2017. Two authors independently conducted the search, extracted the data(including location, time of study, sample size, age, diagnosis, surgical type and exposure factors), and assessed the quality of included studies according to Newcastle-Ottawa Scale(NOS). RevMan 5.3 software was used for the statistical analysis. Results: Totally, 29 studies involving 18486 paties were included in this meta-analysis. Among these, 932 cases were assigned in infection group, while 17554 cases in control group. All articles were evaluated by NOS quality criterial and there were 19 papers graded as A, and 10 papers as grade B. The results of Meta-analysis showed that risk factors related to the surgical site infection in Chinese patients were sex(male)[OR=1.33, 95%CI(1.08, 1.64), P<0.05], age(＞60)[OR=1.44, 95%CI(1.01, 2.04), P<0.05], obesity[OR=2.64, 95%CI(1.35, 5.15), P<0.05], diabetes[OR=3.86, 95%CI(2.68, 5.55), P<0.05], previous infection[OR=6.64, 95%CI (1.29, 34.29), P<0.05], ASA score(＞2)[OR=2.72, 95%CI(1.38, 5.38), P<0.05], urinary incontinence[OR=6.32, 95%CI(3.40, 11.76), P<0.05], cerebrovascular disease[OR=5.73, 95%CI(1.62, 20.35), P<0.05]， allogeneic bone graft[OR=3.02, 95%CI(1.09, 8.34), P<0.05], operation time（＞3 hours）[OR=3.44, 95%CI(1.92, 6.13), P<0.05], blood loss(>1000ml)[OR=2.40, 95%CI(1.73, 4.77), P<0.05], transfusion[OR=2.61, 95%CI(1.36, 5.01), P<0.05], fusion level(＞3)[OR=2.23, 95%CI(1.55, 3.23), P<0.05], not prophylactic antibiotic[OR=5.43, 95%CI(2.66, 11.08), P<0.05], surgical visitors[OR=2.28, 95%CI(1.19, 4.37), P<0.05]. Conclusions: Gender(male), age(over 60 years), obesity, diabetes mellitus, infection history, ASA score(over 2), urinary incontinence, cerebrovascular disease, allograft bone graft, operation time(more than 3 hours), blood loss(>1000ml), blood transfusion, fusion segments(>3), no prophylactic antibiotics and visitors are risk factors for SSI in Chinese population undergoing spinal surgery.