scholarly journals Risk Factors for Surgical Site Infection After Lower Limb Revascularization Surgery in Adults with Peripheral Artery Disease: Protocol for a Systematic Review and Meta-Analysis (Preprint)

10.2196/28759 ◽  
2021 ◽  
Author(s):  
Derek J. Roberts ◽  
Sudhir K. Nagpal ◽  
Henry T. Stelfox ◽  
Timothy Brandys ◽  
Vicente Corrales-Medina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Surgical Site Infection ◽  
Peripheral Artery Disease ◽  
Lower Limb ◽  
Meta Analysis ◽  
Site Infection ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Revascularization Surgery

Risk Factors for Surgical Site Infection After Lower Limb Revascularization Surgery in Adults with Peripheral Artery Disease: Protocol for a Systematic Review and Meta-Analysis (Preprint)

2021 ◽  
Author(s):  
Derek J. Roberts ◽  
Sudhir K. Nagpal ◽  
Henry T. Stelfox ◽  
Timothy Brandys ◽  
Vicente Corrales-Medina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Peripheral Artery Disease ◽  
Lower Limb ◽  
Meta Analysis ◽  
Site Infection ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Revascularization Surgery ◽  
Cumulative Evidence

BACKGROUND Surgical site infections are common, costly, and associated with increased morbidity and potentially mortality after lower limb revascularization surgery (i.e., arterial bypass, endarterectomy, and patch angioplasty). Identifying evidence-informed risk factors for surgical site infection in patients undergoing these surgeries is therefore important. OBJECTIVE We aim to conduct a systematic review and meta-analysis of prognostic studies to identify, synthesize, and determine the certainty in the cumulative evidence associated with reported risk factors for early and delayed surgical site infection after lower limb revascularization surgery in patients with peripheral artery disease. METHODS We will search MEDLINE, EMBASE, the seven databases in Evidence-Based Medicine Reviews, review articles identified during the search, and included article bibliographies. We will include studies of adults (≥18-years-of-age) with peripheral artery disease that reported odds ratios, risk ratios, or hazard ratios adjusted for the presence of other risk factors or confounding variables and relating the potential risk factor(s) of interest to development of surgical site infection after lower limb revascularization surgery. We will exclude studies that did not adjust for confounding, exclusively examined certain high-risk patient cohorts, or included >20% of patients who underwent surgery for indications other than peripheral artery disease. The primary outcomes will be early (in-hospital or ≤30-day) surgical site infection and Szilagyi grade I (cellulitis involving the wound), grade II (infection involving subcutaneous tissue), and grade III (infection involving the vascular graft) surgical site infection. Two investigators will independently extract data and evaluate study risk of bias using the Quality in Prognosis Studies tool. Adjusted risk factor estimates with similar definitions will be pooled using DerSimonian and Laird random-effects models. Heterogeneity will be explored using stratified meta-analyses and meta-regression. Finally, we will use the Grading of Recommendations, Assessment, Development, and Evaluation approach to determine certainty in the estimates of association between the reported risk factors and development of surgical site infection. RESULTS The protocol was submitted to PROSPERO, the international register of systematic reviews, on March 12, 2021. CONCLUSIONS This study will identify, synthesize, and determine the certainty in the cumulative evidence associated with risk factors for early and delayed surgical site infection after lower limb revascularization surgery in patients with peripheral artery disease. Results will be used to inform practice, clinical practice statements and guidelines, and subsequent research. CLINICALTRIAL Submitted to PROSPER on March 12, 2021.

Antiphospholipid antibodies and lower extremity peripheral artery disease: A systematic review and meta-analysis

2020 ◽  
Vol 50 (6) ◽  
pp. 1291-1298
Author(s):  
Mira Merashli ◽  
Tommaso Bucci ◽  
Daniele Pastori ◽  
Pasquale Pignatelli ◽  
Vincenzo Marottoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis ◽  
Peripheral Artery ◽  
Artery Disease

Statins and Major Adverse Limb Events in Patients with Peripheral Artery Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 120 (05) ◽  
pp. 866-875 ◽  
Author(s):  
Daniele Pastori ◽  
Alessio Farcomeni ◽  
Alberto Milanese ◽  
Francesco Del Sole ◽  
Danilo Menichelli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Artery Disease ◽  
Meta Analysis ◽  
Graft Occlusion ◽  
Peripheral Artery ◽  
All Cause Mortality ◽  
Statin Prescription ◽  
Secondary Endpoints ◽  
Artery Disease ◽  
The Impact

Abstract Background Statins are guidelines recommended in patients with peripheral artery disease (PAD) for the prevention of cardiovascular (CV) events. Comprehensive meta-data on the impact of statins on major adverse limb events (MALE) in PAD patients are lacking. We examined the association of statin use with MALE in patients with PAD. Methods We performed a systematic review (registered at PROSPERO: number CRD42019137111) and metanalysis of studies retrieved from PubMed (via MEDLINE) and Cochrane (CENTRAL) databases addressing the impact of statin on MALE including amputation and graft occlusion/revascularization. Secondary endpoints were all-cause death, composite CV endpoints, CV death, and stroke. Results We included 51 studies with 138,060 PAD patients, of whom 48,459 (35.1%) were treated with statins. The analysis included 2 randomized controlled trials, 20 prospective, and 29 retrospective studies. Overall, 11,396 MALE events, 21,624 deaths, 4,852 composite CV endpoints, 4,609 CV deaths, and 860 strokes were used for the analysis. Statins reduced MALE incidence by 30% (pooled hazard ratio [HR]: 0.702; 95% confidence interval [CI]: 0.605–0.815) and amputations by 35% (HR: 0.654; 95% CI: 0.522–0.819), all-cause mortality by 39% (pooled HR: 0.608, 95% CI: 0.543–0.680), CV death by 41% (HR: 0.594; 95% CI: 0.455–0.777), composite CV endpoints by 34% (pooled HR: 0.662; 95% CI: 0.591–0.741) and ischemic stroke by 28% (pooled HR: 0.718; 95% CI: 0.620–0.831). Conclusion Statins reduce the incidence of MALE, all-cause, and CV mortality in patients with PAD. In PAD, a high proportion of MALE events and deaths could be prevented by implementing a statin prescription in this patient population.

Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis

The Lancet ◽  
2013 ◽  
Vol 382 (9901) ◽  
pp. 1329-1340 ◽  
Author(s):  
F Gerald R Fowkes ◽  
Diana Rudan ◽  
Igor Rudan ◽  
Victor Aboyans ◽  
Julie O Denenberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Global Estimates ◽  
Artery Disease
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