Systematic review and meta-analysis of outcomes associated with incisional and organ/space surgical site infections in abdominal surgery patients
Bibliographic record
Abstract
BACKGROUND: Surgical site infections (SSI) are associated with worse healthcare outcomes and increased costs. Recent evidence suggests dissimilar outcomes for SSI subtypes. Abdominal surgery has the largest SSI incidence compared to other surgeries. However, outcomes are often aggregated, masking potential impact differences. This systematic review is the first to separately summarise outcomes associated with incisional and organ/space SSI in abdominal surgery. MATERIALS AND METHODS: A systematic search of PubMed, Embase, and CINAHL was conducted for studies published between 1992 and 5th December 2024. Outcomes of interest were excess hospital length of stay (LOS), mortality risk, and proportions of readmitted and repeat surgery patients. Studies reporting at least one outcome for incisional or organ/space SSI in abdominal surgeries for adults were included. Risk of bias was assessed using the Newcastle Ottawa Scale and the Cochrane Risk of Bias tool for observational studies and randomized controlled trials respectively. RESULTS: Twenty studies were included, pooling 23,567 patients. Five reported outcomes for incisional, one for organ/space and 14 studies for both SSI subtypes. Patients with incisional SSI had an average excess LOS of 5.02 days (3.04-7.01), while organ/space SSI patients had a longer excess LOS of 14.40 days (10.11-18.69). Incisional SSI were associated with weakly increased mortality risk (1.62, 0.74-2.50), while organ/space SSI had increased mortality risk (2.75, 2.56-3.54). Proportions of readmissions were 16% (5-27%) for incisional and 37% (5-69%) for organ/space SSI. Proportions of patients who undergo repeat surgery were 4% (0- 9%) for incisional and 9% (4-14%) for organ/space SSI. CONCLUSION: This study revealed a significant burden of SSI, particularly organ/space SSI, which are associated with worse overall outcomes. Infection prevention and control strategies to reduce the impact and cost of SSI might be improved, with a need for targeted efforts against organ/space SSI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.044 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.022 | 0.042 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".