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Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review

Background: The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to...

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Autores principales: Cheng, Hang, Chen, Brian Po-Han, Soleas, Ireena M., Ferko, Nicole C., Cameron, Chris G., Hinoul, Piet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685201/
https://www.ncbi.nlm.nih.gov/pubmed/28832271
http://dx.doi.org/10.1089/sur.2017.089
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author Cheng, Hang
Chen, Brian Po-Han
Soleas, Ireena M.
Ferko, Nicole C.
Cameron, Chris G.
Hinoul, Piet
author_facet Cheng, Hang
Chen, Brian Po-Han
Soleas, Ireena M.
Ferko, Nicole C.
Cameron, Chris G.
Hinoul, Piet
author_sort Cheng, Hang
collection PubMed
description Background: The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to provide an in-depth understanding of the relation between operating time and SSI. Patients and Methods: This review included 81 prospective and retrospective studies. Along with study design, likelihood of SSI, mean operative times, time thresholds, effect measures, confidence intervals, and p values were extracted. Three meta-analyses were conducted, whereby odds ratios were pooled by hourly operative time thresholds, increments of increasing operative time, and surgical specialty. Results: Pooled analyses demonstrated that the association between extended operative time and SSI typically remained statistically significant, with close to twice the likelihood of SSI observed across various time thresholds. The likelihood of SSI increased with increasing time increments; for example, a 13%, 17%, and 37% increased likelihood for every 15 min, 30 min, and 60 min of surgery, respectively. On average, across various procedures, the mean operative time was approximately 30 min longer in patients with SSIs compared with those patients without. Conclusions: Prolonged operative time can increase the risk of SSI. Given the importance of SSIs on patient outcomes and health care economics, hospitals should focus efforts to reduce operative time.
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spelling pubmed-56852012017-11-20 Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review Cheng, Hang Chen, Brian Po-Han Soleas, Ireena M. Ferko, Nicole C. Cameron, Chris G. Hinoul, Piet Surg Infect (Larchmt) Original Articles Background: The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to provide an in-depth understanding of the relation between operating time and SSI. Patients and Methods: This review included 81 prospective and retrospective studies. Along with study design, likelihood of SSI, mean operative times, time thresholds, effect measures, confidence intervals, and p values were extracted. Three meta-analyses were conducted, whereby odds ratios were pooled by hourly operative time thresholds, increments of increasing operative time, and surgical specialty. Results: Pooled analyses demonstrated that the association between extended operative time and SSI typically remained statistically significant, with close to twice the likelihood of SSI observed across various time thresholds. The likelihood of SSI increased with increasing time increments; for example, a 13%, 17%, and 37% increased likelihood for every 15 min, 30 min, and 60 min of surgery, respectively. On average, across various procedures, the mean operative time was approximately 30 min longer in patients with SSIs compared with those patients without. Conclusions: Prolonged operative time can increase the risk of SSI. Given the importance of SSIs on patient outcomes and health care economics, hospitals should focus efforts to reduce operative time. Mary Ann Liebert, Inc. 2017-08-01 2017-08-01 /pmc/articles/PMC5685201/ /pubmed/28832271 http://dx.doi.org/10.1089/sur.2017.089 Text en © Hang Cheng et al., 2017; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Articles
Cheng, Hang
Chen, Brian Po-Han
Soleas, Ireena M.
Ferko, Nicole C.
Cameron, Chris G.
Hinoul, Piet
Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title_full Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title_fullStr Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title_full_unstemmed Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title_short Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review
title_sort prolonged operative duration increases risk of surgical site infections: a systematic review
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685201/
https://www.ncbi.nlm.nih.gov/pubmed/28832271
http://dx.doi.org/10.1089/sur.2017.089
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