Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis

Background The aim of this meta-analysis is to comprehensively review and quantify the excess risk of surgical site infections (SSI) in obese patients following colorectal surgery. Methods A systematic electronic search of the MEDLINE and EMBASE databases identified studies that investigated the association of obesity, defined by body mass index (BMI) with SSI among colorectal surgery patients. Results Twelve studies were included in the final analysis. Patients with BMI = 30 kg/m(2) were at 1.5 times (pooled OR 1.51, 95% CI: 1.39, 1.63, p < 0.001) higher odds of developing SSI after colorectal surgery when compared to BMI < 30 kg/m(2). Subgroup analysis of the eight studies that investigated only elective procedures showed that the odds of developing SSI when BMI = 30 kg/m(2) is 1.6 times that of those with BMI < 30 kg/m(2) (pooled OR 1.60; 95% CI 1.34, 1.86; p < 0.001). The odds of having SSI when BMI is 25-29.9 kg/m(2) are 1.2 times than those with BMI < 25 kg/m(2) (pooled OR 1.17; 95% CI 1.07, 1.28; p < 0.001). Conclusion Overweight and obese patients carry at least 20% and 50% higher odds of developing SSI after colorectal surgery compared to normal weight patients, respectively.