Association between metabolic syndrome and short‐term adverse events in skull base surgery

Goshtasbi, Khodayar; Abiri, Arash; Torabi, Sina J.; Bitner, Benjamin F.; Hsu, Frank P.K.; Kuan, Edward C.

doi:10.1002/alr.23087

Cited by 1 publication

(3 citation statements)

References 11 publications

(28 reference statements)

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“…Inclusion and Exclusion Criteria). The most commonly reported types of surgery were orthopaedic (22%) 5 , 6 , 15 , 26 , 27 , 29 , 46 – 48 , 67 , 72 , 73 , 75 , 78 , cardiac (21%) 19 , 20 , 37 , 38 , 41 , 42 , 50 , 51 , 54 , 63 , 64 , 69 , 76 , vascular (13%) 4 , 24 , 53 , 62 , 65 , 68 , 70 , 79 , hepatobiliary (11%) 50 – 56 , gastroenterology (6%) 57 – 60 , bariatric (5%) 39 , 43 , 57 , urology (5%) 21 , 58 , 74 , and plastics (5%) 52 , 56 , 77 (see Table 3 . Included Studies).…”

Section: Resultsmentioning

confidence: 99%

“…Included Studies). Most studies reported North America data ( n =40) 4 – 6 , 15 , 23 , 27 , 30 – 35 , 38 – 40 , 43 , 46 – 49 , 52 , 53 , 55 – 62 , 65 – 67 , 70 , 73 , 75 – 78 , 80 , with the remaining spanning Europe 19 , 21 , 22 , 24 , 28 , 42 , 44 , 50 , 51 , 64 , 68 , 81 , the Middle East 20 , Asia 37 , 41 , 45 , 71 , 72 , 74 , 82 , 83 , Africa 63 , and South America 54 . The assessed risk of bias of the included studies ranged from 5 to 8 (fair to good) out of a possible 9 stars when assessed using the NOS.…”

Section: Resultsmentioning

confidence: 99%

“…Across these studies, a total of 298 619 patients with MetS underwent surgery versus 3 888 671 surgical patients without MetS. In 13 of 24 studies, an increased length of hospital stay was reported across a range of surgeries including cardiac 42 , 64 , 76 , endocrine 59 , hepatobiliary 34 , orthopaedic 26 , 48 , 67 , 72 , 78 , 86 , plastics 77 , and urology 74 . Two studies focusing on orthopaedic and hepatobiliary surgical patients 27 , 55 reported those with MetS were at less risk of increased hospital LOS.…”

Section: Resultsmentioning

confidence: 99%

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Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals

Norris,

Gow,

Arthur

et al. 2023

International Journal of Surgery

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Background: Metabolic syndrome 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 reported to affect 46% of surgical patients. For people with metabolic syndrome who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations. The aim of this study is to review the current evidence on risks of surgical complications in patients with metabolic syndrome compared to those without metabolic syndrome. 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 metabolic syndrome and 11,248,114 patients without metabolic syndrome. Compared to individuals without the condition, individuals with metabolic syndrome were at an increased risk of mortality (OR 1.75 95% CIs [1.36-2.24]; P <0.01); all surgical site infection types as well as dehiscence (OR 1.64 95% CIs [1.52 -1.77]; P <0.01); cardiovascular complications (OR 1.56 95% CIs [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% CIs [0.39-0.9]; P <0.01); and hospital readmission (OR 1.55 95% CIs [1.41-1.71]; P <0.01). Conclusion: Metabolic syndrome 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 metabolic syndrome in surgical populations there is a lack of evidence on interventions for reducing surgical complications in patients with metabolic syndrome. The authors suggest prioritising interventions across the surgical continuum that include (1) preoperative screening for metabolic syndrome; (2) surgical prehabilitation; (3) intraoperative monitoring and management; and (4) postoperative rehabilitation and follow-up.

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