Evidence map›Paper›PMID 37433918›Full record

SynthesisThe British journal of surgery2023

Prognostic models for surgical-site infection in gastrointestinal surgery: systematic review.

Kenneth A McLean, Tanvi Goel, Samuel Lawday, Aya Riad, Joana Simoes, Stephen R Knight, Dhruva Ghosh, James C Glasbey, Aneel Bhangu, Ewen M Harrison and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Development and validation of an anastomotic risk score for use in a randomized clinical trial on defunctioning stoma use in low anterior resection for rectal cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
    Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kenneth A McLeanDepartment of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0001-6482-9086
Tanvi GoelIndia Hub, NIHR Global Health Research Unit on Global Surgery, Ludhiana, India.
Samuel LawdayBristol Centre for Surgical Research, University of Bristol, Bristol, UK.
Aya RiadDepartment of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
Joana SimoesInstitute of Translational Medicine, University of Birmingham, Birmingham, UK.ORCID 0000-0002-5294-6282
Stephen R KnightDepartment of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0003-0448-3719
Dhruva GhoshIndia Hub, NIHR Global Health Research Unit on Global Surgery, Ludhiana, India.
James C GlasbeyInstitute of Translational Medicine, University of Birmingham, Birmingham, UK.
Aneel BhanguInstitute of Translational Medicine, University of Birmingham, Birmingham, UK.
Ewen M HarrisonDepartment of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
NIHR Global Health Research Unit on Global Surgery

Funding

Global Health Research Unit Grant NIHR 16.136.79National Institute for Health ResearchRobertson Trust Research Fellowship RTRF/22/010Royal College of Surgeons of Edinburgh
6 · The paper itself

Abstract

backgroundIdentification of patients at high risk of surgical-site infection may allow clinicians to target interventions and monitoring to minimize associated morbidity. The aim of this systematic review was to identify and evaluate prognostic tools for the prediction of surgical-site infection in gastrointestinal surgery.

methodsThis systematic review sought to identify original studies describing the development and validation of prognostic models for 30-day SSI after gastrointestinal surgery (PROSPERO: CRD42022311019). MEDLINE, Embase, Global Health, and IEEE Xplore were searched from 1 January 2000 to 24 February 2022. Studies were excluded if prognostic models included postoperative parameters or were procedure specific. A narrative synthesis was performed, with sample-size sufficiency, discriminative ability (area under the receiver operating characteristic curve), and prognostic accuracy compared.

resultsOf 2249 records reviewed, 23 eligible prognostic models were identified. A total of 13 (57 per cent) reported no internal validation and only 4 (17 per cent) had undergone external validation. Most identified operative contamination (57 per cent, 13 of 23) and duration (52 per cent, 12 of 23) as important predictors; however, there remained substantial heterogeneity in other predictors identified (range 2-28). All models demonstrated a high risk of bias due to the analytic approach, with overall low applicability to an undifferentiated gastrointestinal surgical population. Model discrimination was reported in most studies (83 per cent, 19 of 23); however, calibration (22 per cent, 5 of 23) and prognostic accuracy (17 per cent, 4 of 23) were infrequently assessed. Of externally validated models (of which there were four), none displayed 'good' discrimination (area under the receiver operating characteristic curve greater than or equal to 0.7).

conclusionThe risk of surgical-site infection after gastrointestinal surgery is insufficiently described by existing risk-prediction tools, which are not suitable for routine use. Novel risk-stratification tools are required to target perioperative interventions and mitigate modifiable risk factors.

Indexed as

Digestive System Surgical ProceduresSurgical Wound InfectionHumansPrognosisRisk AssessmentRisk Factors

Identifiers

PMID37433918
PMCPMC10564404

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.