Dataset Information

Impact of surgical-site infection on health utility values: a meta-analysis.

ABSTRACT:

Background

Surgical-site infections (SSIs) are recognized as negatively affecting patient quality of life. No meta-analysis of SSI utility values is available in the literature to inform estimates of this burden and investment decisions in prevention.

Methods

A systematic search of PubMed, MEDLINE, CINAHL, and the National Health Service Economic Evaluation Database was performed in April 2022 in accordance with PROSPERO registration CRD 42021262633. Studies were included where quality-of-life data were gathered from adults undergoing surgery, and such data were presented for those with and without an SSI at similar time points. Two researchers undertook data extraction and quality appraisal independently, with a third as arbiter. Utility values were converted to EuroQol 5D (EQ-5D™) estimates. Meta-analyses were conducted using a random-effects model across all relevant studies, with subgroup analyses on type and timing of the SSI.

Results

In total, 15 studies with 2817 patients met the inclusion criteria. Six studies across seven time points were used in the meta-analysis. The pooled mean difference in EQ-5D™ utility in all studies combined was -0.08 (95 per cent c.i. -0.11 to -0.05; prediction interval -0.16 to -0.01; I2 = 40 per cent). The mean difference in EQ-5D™ utility associated with deep SSI was -0.10 (95 per cent c.i. -0.14 to -0.06; I2 = 0 per cent) and the mean difference in EQ-5D™ utility persisted over time.

Conclusion

The present study provides the first synthesized estimate of SSI burden over the short and long term. EQ-5D™ utility estimates for a range of SSIs are essential for infection prevention planning and future economic modelling.

SUBMITTER: McFarland AM

PROVIDER: S-EPMC10361680 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of surgical-site infection on health utility values: a meta-analysis.

McFarland Agi M AM Manoukian Sarkis S Mason Helen H Reilly Jacqui S JS

The British journal of surgery 20230701 8

<h4>Background</h4>Surgical-site infections (SSIs) are recognized as negatively affecting patient quality of life. No meta-analysis of SSI utility values is available in the literature to inform estimates of this burden and investment decisions in prevention.<h4>Methods</h4>A systematic search of PubMed, MEDLINE, CINAHL, and the National Health Service Economic Evaluation Database was performed in April 2022 in accordance with PROSPERO registration CRD 42021262633. Studies were included where qu ...[more]

PMID: 37303251

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Project description:Healthcare-associated infections pose one of the most severe threats to patients' health and remain a major challenge for healthcare providers globally. Among healthcare-associated infections, surgical site infection is one of the most commonly reported infections. It remains a major cause of morbidity and mortality across the world. The aim of this study was to provide a pooled incidence of surgical site infection among patients on a regional and global scale. This study was conducted under the PRISMA guidelines developed for systematic review and meta-analysis. The studies were searched using electronic databases (SCOPUS, PubMed/MEDLINE, Web of Science, Google Scholar, DOAJ, and MedNar) from June 1st, 2022 to August 4th, 2022, using Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. The quality of the study was assessed using the Joanna Briggs Institute Critical Assessment tool to determine the relevance of each included article to the study. A comprehensive meta-analysis version 3 was used to estimate the pooled prevalence of surgical site infections among the patients. A total of 2124 articles were retrieved from the included electronic databases. Finally, after applying inclusion criteria, 43 articles conducted in 39 countries were included in the current study. The global pooled incidence of SSI was found to be 2.5% (95% CI: 1.6, 3.7). Based on the subgroup analysis by WHO region and survey period, the incidence of SSI was 2.7% (95% CI: 2.2, 3.3%) and 2.5% (95% CI: 1.8, 3.5%), respectively. The highest incidence was reported in the African Region (7.2% [95% CI: 4.3, 11.8%]) and among studies conducted between 1996 and 2001 (2.9% [95% CI: 0.9%, 8.8%]). This study revealed that the overall pooled incidence of SSI was 2.5%. SSI estimates varied among the WHO regions of the world. However, the highest incidence (2.7%) was observed in the African region. This indicates that there is a need to implement safety measures, including interventions for SSI prevention to reduce SSI and improve patient safety.

Project description:BackgroundUsing appropriate health state utility values (HSUVs) is critical for economic evaluation of new lung cancer interventions, such as low-dose computed tomography screening and immunotherapy. Therefore, we provide a systematic review and meta-analysis of community- and choice-based HSUVs for lung cancer.MethodsOn 6 March 2017, we conducted a systematic search of the following databases: Embase, Ovid MEDLINE, Web of Science, Cochrane CENTRAL, Google Scholar, and the School of Health and Related Research Health Utility Database. The search was updated on 17 April 2019. Studies reporting mean or median lung cancer-specific HSUVs including a measure of variance were included and assessed for relevance and validity. Studies with high relevance (i.e. community- and choice-based) were further analysed. Mean HSUVs were pooled using random-effects models for all stages, stages I-II, and stages III-IV. For studies with a control group, we calculated the disutility due to lung cancer. A sensitivity analysis included only the methodologically most comparable studies (i.e. using the EQ-5D instrument and matching tariff). Subgroup analyses were conducted by time to death, histology, sex, age, treatment modality, treatment line, and progression status.ResultsWe identified and analysed 27 studies of high relevance. The pooled HSUV was 0.68 (95% confidence interval [CI] 0.61-0.75) for all stages, 0.78 (95% CI 0.70-0.86) for stages I-II, and 0.69 (95% CI 0.65-0.73) for stages III-IV (p = 0.02 vs. stage I-II). Heterogeneity was present in each pooled analysis (p < 0.01; I2 = 92-99%). Disutility due to lung cancer ranged from 0.11 (95% CI 0.05-0.17) to 0.27 (95% CI 0.18-0.36). In the sensitivity analysis with the methodologically most comparable studies, stage-specific HSUVs varied by country. Such studies were only identified for Canada, China, Spain, the UK, the USA, Denmark, Germany, and Thailand. In the subgroup analysis by time to death, HSUVs for metastatic non-small-cell lung cancer ranged from 0.83 (95% CI 0.82-0.85) at ≥ 360 days from death to 0.56 (95% CI 0.46-0.66) at < 30 days from death. Among patients with metastatic non-small-cell lung cancer, HSUVs were lower for those receiving third- or fourth-line treatment and for those with progressed disease. Results of subgroup analyses by histology, sex, age, and treatment modality were ambiguous.ConclusionsThe presented evidence supports the use of stage- and country-specific HSUVs. However, such HSUVs are unavailable for most countries. Therefore, our pooled HSUVs may provide the best available stage-specific HSUVs for most countries. For metastatic non-small-cell lung cancer, adjusting for the decreased HSUVs in the last year of life may be considered, as may further stratification of HSUVs by treatment line or progression status. If required, HSUVs for other health states may be identified using our comprehensive breakdown of study characteristics.

Dataset Information

Impact of surgical-site infection on health utility values: a meta-analysis.

Background

Methods

Results

Conclusion

Publications

Impact of surgical-site infection on health utility values: a meta-analysis.

Similar Datasets

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