Association between smoking and surgical site infection after spine surgery: a meta-analysis / 国际生物医学工程杂志

ABSTRACT

Objective:To investigate the effect of smoking on surgical site infection (SSI) after spinal surgery, and to provide evidence-based information for preventing the occurrence of SSI after spinal surgery.Methods:Literature searches were independently conducted in PubMed, EMBASE, CNKI, Wanfang and other databases from January 2000 to June 2020 by two researchers. Stata13.0 software was used to analyze the included literatures. Statistical analysis and subgroup analysis were preformed based on different population, research types, and adjustments.Results:44 literatures were finally included, involving 79 601 samples including 3 016 cases in the infected group. Compared with non-smokers, the combined odds ratio ( OR) of SSI in smokers after spinal surgery was 1.45 (95% CI 1.25~1.68). The results of subgroup analysis showed that the risk of SSI in the yellow population and smokers after spinal surgery was 1.69 times that of the control group (95% CI 1.35~2.12), and no such association was found in the white population. Smokers in the case-control studies and cohort studies had a higher risk of SSI after spinal surgery than that of the control group. Regardless of whether the effect size was adjusted, smokers had a higher risk of SSI after spinal surgery than that of the control group. Conclusions:This study has the advantages of using the latest data, including more literature, and analyzing ethnicity for the first time. The results show that smokers have a higher risk of SSI after spinal surgery. Clinically, patients should be encouraged to quit smoking to reduce the risk of SSI after spinal surgery. However, when to quit smoking to achieve the maximum benefit still needs further research.