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Journal article
Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals
International Journal of Surgery , Vol.110(1), pp.541-553
2024
PMID: 37916943
Abstract
Background:
Metabolic syndrome (MetS) is characterised by the presence of at least three of the five following components: insulin resistance, obesity, chronic hypertension, elevated serum triglycerides, and decreased high-density lipoprotein cholesterol concentrations. It is estimated to affect 1 in 3 people around the globe and is reported to affect 46% of surgical patients. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with nonaffected populations. The aim of this study is to review the current evidence on the risks of surgical complications in patients with MetS compared to those without MetS.
Methods:
Systematic review and meta-analysis using PRISMA and AMSTAR reporting guidelines.
Results:
The meta-analysis included 63 studies involving 1 919 347 patients with MetS and 11 248 114 patients without MetS. Compared to individuals without the condition, individuals with MetS were at an increased risk of mortality (OR 1.75 95% CI: 1.36–2.24; P<0.01); all surgical site infection types as well as dehiscence (OR 1.64 95% CI: 1.52–1.77; P<0.01); cardiovascular complications (OR 1.56 95% CI: 1.41–1.73; P<0.01) including myocardial infarction, stroke, cardiac arrest, cardiac arrythmias and deep vein thrombosis; increased length of hospital stay (MD 0.65 95% CI: 0.39–0.9; P<0.01); and hospital readmission (OR 1.55 95% CI: 1.41–1.71; P<0.01).
Conclusion:
MetS is associated with a significantly increased risk of surgical complications including mortality, surgical site infection, cardiovascular complications, increased length of stay, and hospital readmission. Despite these risks and the high prevalence of MetS in surgical populations there is a lack of evidence on interventions for reducing surgical complications in patients with MetS. The authors suggest prioritising interventions across the surgical continuum that include (1) preoperative screening for MetS; (2) surgical prehabilitation; (3) intraoperative monitoring and management; and (4) postoperative rehabilitation and follow-up.
Details
- Title
- Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals
- Authors
- Philip Norris (Author) - University of Southern QueenslandJeff Gow (Author) - University of Southern QueenslandThomas Arthur (Author) - University of Southern QueenslandAaron Conway (Author) - University Health NetworkFergal J. Fleming (Author) - University of Rochester Medical CenterNicholas Ralph (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health
- Publication details
- International Journal of Surgery , Vol.110(1), pp.541-553
- Publisher
- Elsevier Ltd
- Date published
- 2024
- DOI
- 10.1097/JS9.0000000000000834
- ISSN
- 1743-9159; 1743-9191
- PMID
- 37916943
- Copyright note
- This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/.
- Data Availability
- Data from the review is available on request.
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991003697902621
- Output Type
- Journal article
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