Identifying potential predictors of surgical site infection risk following cardiac surgery: a scoping review

J Hosp Infect. 2024 Dec 14:S0195-6701(24)00404-3. doi: 10.1016/j.jhin.2024.12.002. Online ahead of print.

Abstract

Objectives: This scoping review was undertaken to identify risk predictions models and preoperative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high-risk of SSI, and therefore guide a national SSI prevention strategy.

Methods: A scoping review to systematically identify and map out existing research evidence on preoperative predictors of SSI was conducted in two stages. Stage 1 reviewed prediction modelling studies of SSI in cardiac surgery. Stage 2 identified primary studies and systematic reviews of novel cardiac SSI predictors.

Results: The search identified 7887 unique records; 7154 studies were excluded at abstract screening and 733 studies selected for full-text assessment. Twenty-nine were included for Stage 1 and reported the development (n = 14), validation (n = 13), or both the development and validation (n = 2) of 52 SSI risk prediction models including 67 different preoperative predictors. The remaining 703 studies were re-assessed for Stage 2; 49 studies met the inclusion criteria, and 56 novel preoperative predictors not yet assessed in models were identified.

Conclusions: This review identified 123 preoperative predictors of SSI risk following cardiac surgery, 56 of which have not been previously included in the development of cardiac SSI prediction models. These candidate predictors will be a valuable resource in the future development of risk prediction scores and may be relevant to SSI risk prediction in other surgical specialities.

Keywords: Cardiac surgery; risk prediction; scoping review; surgical site infection.