Risk factors for infection in patients undergoing shoulder arthroscopy: a systematic review and meta-analysis

• Published in: The Journal of hospital infection 2024-08, Vol.150, p.72-82
• Main Authors: Lei, Y., Zeng, Y., Xia, W., Xie, J., Hu, C., Lan, Z., Ma, D., Cai, Y., He, L., Kong, D., Huang, X., Yan, H., Chen, H., Li, Z., Wang, X.
• Format: Article
• Language: English
• Subjects: Arthroscopy; Infection; Meta-analysis; Risk factors; Shoulder; Surgery
• ISSN: 0195-6701; 1532-2939; 1532-2939
• DOI: 10.1016/j.jhin.2024.04.025

We conducted a meta-analysis to determine the risk of infection following shoulder arthroscopy and to identify risk factors for infection. We systematically searched the PubMed/Medline, Embase and Cochrane Library databases, as well as the reference lists of previous systematic reviews and meta-analyses; manual searches were also performed. A random-effects model was employed to estimate pooled odds ratios (ORs), based on sample size, the P-value of Egger's test and heterogeneity among studies. Of the 29,342 articles screened, 16 retrospective studies comprising 74,759 patients were included. High-quality evidence showed that patients with diabetes (OR, 1.30; 95% confidence interval (CI), 1.20–1.41) or hypertension (OR, 1.26; 95% CI, 1.10–1.44) had a higher risk of infection, while moderate quality evidence showed that patients with obesity (body mass index ≥30 kg/m2) (OR, 1.42; 95% CI, 1.28–1.57), those who were male (OR, 1.65; 95% CI, 1.12–2.44), those who had an American Society of Anesthesiologists (ASA) class ≥3 (OR, 2.02; 95% CI, 1.02–3.99) and those who had a history of smoking (OR, 2.44; 95% CI, 1.39–4.28) had a higher risk of infection. The meta-analysis revealed that there was no association between age, time of surgery, or alcohol consumption and infection. This meta-analysis identified six significant risk factors for infection following shoulder arthroscopy including diabetes, obesity, hypertension, male sex, ASA class, history of smoking. These patient-related risk factors may help identify postoperative patients at higher risk for infection following shoulder arthroscopy.