Abstract
Background
Surgical-site infections (SSIs) are recognized as negatively affecting patient quality of life. No meta-analysis of SSI utility values is available in the literature to inform estimates of this burden and investment decisions in prevention.
Methods
A systematic search of PubMed, MEDLINE, CINAHL, and the National Health Service Economic Evaluation Database was performed in April 2022 in accordance with PROSPERO registration CRD 42021262633. Studies were included where quality-of-life data were gathered from adults undergoing surgery, and such data were presented for those with and without an SSI at similar time points. Two researchers undertook data extraction and quality appraisal independently, with a third as arbiter. Utility values were converted to EuroQol 5D (EQ-5D™) estimates. Meta-analyses were conducted using a random-effects model across all relevant studies, with subgroup analyses on type and timing of the SSI.
Results
In total, 15 studies with 2817 patients met the inclusion criteria. Six studies across seven time points were used in the meta-analysis. The pooled mean difference in EQ-5D™ utility in all studies combined was –0.08 (95 per cent c.i. −0.11 to −0.05; prediction interval −0.16 to −0.01; I2 = 40 per cent). The mean difference in EQ-5D™ utility associated with deep SSI was −0.10 (95 per cent c.i. −0.14 to −0.06; I2 = 0 per cent) and the mean difference in EQ-5D™ utility persisted over time.
Conclusion
The present study provides the first synthesized estimate of SSI burden over the short and long term. EQ-5D™ utility estimates for a range of SSIs are essential for infection prevention planning and future economic modelling.
Surgical-site infections (SSIs) are recognized as negatively affecting patient quality of life. No meta-analysis of SSI utility values is available in the literature to inform estimates of this burden and investment decisions in prevention.
Methods
A systematic search of PubMed, MEDLINE, CINAHL, and the National Health Service Economic Evaluation Database was performed in April 2022 in accordance with PROSPERO registration CRD 42021262633. Studies were included where quality-of-life data were gathered from adults undergoing surgery, and such data were presented for those with and without an SSI at similar time points. Two researchers undertook data extraction and quality appraisal independently, with a third as arbiter. Utility values were converted to EuroQol 5D (EQ-5D™) estimates. Meta-analyses were conducted using a random-effects model across all relevant studies, with subgroup analyses on type and timing of the SSI.
Results
In total, 15 studies with 2817 patients met the inclusion criteria. Six studies across seven time points were used in the meta-analysis. The pooled mean difference in EQ-5D™ utility in all studies combined was –0.08 (95 per cent c.i. −0.11 to −0.05; prediction interval −0.16 to −0.01; I2 = 40 per cent). The mean difference in EQ-5D™ utility associated with deep SSI was −0.10 (95 per cent c.i. −0.14 to −0.06; I2 = 0 per cent) and the mean difference in EQ-5D™ utility persisted over time.
Conclusion
The present study provides the first synthesized estimate of SSI burden over the short and long term. EQ-5D™ utility estimates for a range of SSIs are essential for infection prevention planning and future economic modelling.
| Original language | English |
|---|---|
| Article number | znad144 |
| Pages (from-to) | 942-949 |
| Number of pages | 8 |
| Journal | British Journal of Surgery |
| Volume | 110 |
| Issue number | 8 |
| Early online date | 12 Jun 2023 |
| DOIs | |
| Publication status | Published - Aug 2023 |
ASJC Scopus subject areas
- Surgery
Documents and Links
- McFarland, A. M. et al. (2023) Impact of surgical-site infection on health utility values: a meta-analysis
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.