Article ; Online: Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals.
International journal of surgery (London, England)
2024 Volume 110, Issue 1, Page(s) 541–553
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 ... ...
| 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. |
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| MeSH term(s) | Humans ; Metabolic Syndrome/complications ; Metabolic Syndrome/epidemiology ; Obesity/complications ; Surgical Wound Infection/epidemiology ; Insulin Resistance ; Myocardial Infarction ; Risk Factors |
| Language | English |
| Publishing date | 2024-01-01 |
| Publishing country | United States |
| Document type | Meta-Analysis ; Systematic Review ; Journal Article |
| ZDB-ID | 2212038-5 |
| ISSN | 1743-9159 ; 1743-9191 |
| ISSN (online) | 1743-9159 |
| ISSN | 1743-9191 |
| DOI | 10.1097/JS9.0000000000000834 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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