Warm Weather and Surgical Site Infections: A Meta-analysis

Abstract

Background: Seasonal variability, in terms of warm weather, has been demonstrated to be a significant risk factor for surgical site infections (SSIs). However, this remains an underexposed risk factor for SSIs, and many clinicians are not aware of this. Therefore, a systematic review and meta-analysis has been conducted to investigate and quantify this matter. Methods: Articles were searched in Embase, Medline Ovid, Web of Science, Cochrane Central, and Google Scholar, and data were extracted from relevant studies. Meta-analysis used random effects models to estimate and compare the pooled odds ratios (OR) and corresponding confidence intervals (CIs) of surgery performed during the warmest period of the year and the colder period of the year. Results: The systematic review included 20 studies (58,599,475 patients), of which 14 studies (58,441,420 patients) were included for meta-analysis. Various types of surgical procedures across different geographic regions were included. The warmest period of the year was associated with a statistically significant increase in the risk of SSIs (OR 1.39, 95%CI: [1.34-1.45], P < 0.0001). Selection of specific types of surgical procedures (eg, orthopedic or spinal surgery) significantly altered this increased risk. Conclusions: The current meta-analysis showed that warm weather seasons are associated with a statistically significant risk increasement of 39% in developing SSIs. This significant risk factor might aid clinicians in preoperative patient information, possible surgical planning adjustment for high risk patients, and potentially specific antibiotic treatments during the warmer weather seasons that could result in decrease of SSIs.

Temporal patterns and clinical characteristics of healthcare-associated infections in surgery patients: A retrospective study in a major Chinese tertiary hospital

“…Conversely, for BI and SSI, the peak was in the summer season. The higher ambient temperature and relative humidity during summer may facilitate the colonization and transmission of pathogens such as Acinetobacter, E. coli , and Staphylococcus aureus , thereby increasing the risk of acquiring BI and SSI [24] , [25] , [26] , [27] . These diverse time series patterns observed among different types of HAIs may help explain the inconsistencies found in previous studies regarding the seasonal peaks of HAIs [ 10 , 12 ].…”

The Association of Season of Surgery and Patient Reported Outcomes following Total Hip Arthroplasty

“… 2 - 4 However, complications following total knee arthroplasty (TKA) have been found to be higher during the summer months 5 with increased risk for infections found during warmer weather. 6 - 8 In a large database study, total hip arthroplasty (THA) and TKA procedures performed in December were shown to have lower rates of complications with decreased lengths of stay postoperatively. 9 Alternatively, another study noted increased rates of periprosthetic infection following THA occur during the winter, 10 although this was not demonstrated in a population of unicompartmental knee arthroplasty patients.…”

A meta-analysis of risk factors for non-superficial surgical site infection following spinal surgery

“…In previous studies, postoperative SSI occurs in approximately 1–15% of patients who undergo spinal surgery [ 3 , 4 ]. This postoperative complication could not only lead to poor prognosis of patients, but also increase medical costs [ 5 , 6 ]. The Centers for Disease Control and Prevention (CDC) is responsible for monitoring SSI.…”