Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis
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The aim of this meta-analysis is to comprehensively review and quantify the excess risk of surgical site infections (SSI) in obese patients following colorectal surgery.
A systematic electronic search of the MEDLINE and EMBASE databases identified studies that investigated the association of obesity, defined by body mass index (BMI) with SSI among colorectal surgery patients.
Twelve studies were included in the final analysis. Patients with BMI ≥30 kg/m2 were at 1.5 times (pooled OR 1.51, 95% CI: 1.39, 1.63, p < 0.001) higher odds of developing SSI after colorectal surgery when compared to BMI <30 kg/m2. Subgroup analysis of the eight studies that investigated only elective procedures showed that the odds of developing SSI when BMI ≥30 kg/m2 is 1.6 times that of those with BMI <30 kg/m2 (pooled OR 1.60; 95% CI 1.34, 1.86; p < 0.001). The odds of having SSI when BMI is 25–29.9 kg/m2 are 1.2 times than those with BMI <25 kg/m2 (pooled OR 1.17; 95% CI 1.07, 1.28; p < 0.001).
Overweight and obese patients carry at least 20% and 50% higher odds of developing SSI after colorectal surgery compared to normal weight patients, respectively.
KeywordsObesity Surgical site infection Colorectal surgery
The authors thank Ms. Megan Neumann, The Prince Charles Hospital librarian for her assistance with literature review; Dr. David Smith, for his statistical advice; and Dr. Manju Chandrasegaram, for editing the article.
All the authors have provided substantial contributions to the conception and the design of the study, or the acquisition, analysis, or interpretation of the data for the work and were involved in drafting of the work or revising it critically for important intellectual content. All the authors have provided final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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