title: Risk factors for postoperative intra-abdominal septic complications after surgery in Crohn's disease: A meta-analysis of observational studies.
abstract: OBJECTIVE
  Postoperative intra-abdominal septic complications [IASCs] are the most feared risks of surgery for Crohn's disease[CD]. The risk factors for IASCs still remain controversial. The aim of this study was to assess the risk factors for IASCs in CD patients undergoing abdominal surgery.
  
  
  METHODS
  MEDLINE, Cochrane Library, and EMBASE were searched to identify observational studies reporting the risk factors for IASCs in CD patients. A meta-analysis was conducted to investigate the impact of various risk factors on IASCs in CD. The GRADE [Grading of Recommendations Assessment, Development and Evaluation] approach was used for quality assessment of evidence on outcome levels.
  
  
  RESULTS
  This review included 15 studies evaluating 3807 patients undergoing 4189 operations. The meta-analyses found that low albumin levels (odds ratio [OR]: 1.93; 95% confidence interval [CI]: 1.362.75), preoperative steroids use [OR: 1.99; 95% CI: 1.54-2.57], a preoperative abscess [OR: 1.94; 95% CI: 1.263.0], previous surgery history [OR: 1.50; 95% CI: 1.151.97] may be risk factors for IASCs. There were no associations between anastomosis methods [OR: 0.94; 95% CI: 0.58-1.53], biologics therapy [OR: 1.29; 95% CI: 0.792.11], and immunomodulator use [OR: 1.07; 95% CI: 0.661.73] with the risk of IASCs. Due to observational design, the quality of evidence was regarded low or moderate for these risk factors by the GRADE approach.
  
  
  CONCLUSIONS
  This meta-analysis provides some evidence that steroids use, previous surgical history, a preoperative abscess, and low albumin levels may be associated with higher rates of IASCs in CD. Knowledge about those risk factors may influence treatment and procedure-related decisions, and possibly reduce the ss rate.
authors.affiliation: Department of General Surgery, Third Affiliated Hospital of Guangxi Traditional Chinese Medicinal University, Liuzhou, Guangxi, China.
authors.forename: Wenpeng
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China doctyb@126.com.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Laboratory, Youjiang Medical College For Nationalities, Youjiang, Guanxi, China.
authors.forename: Legen
authors.initials: L
authors.lastname: Nong
authors.affiliation: Department of Laboratory, Third Affiliated Hospital of Guangxi Traditional Chinese Medicinal University, Liuzhou, Guangxi, China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Sun
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology*; D057868:Anastomotic Leak / Q000209:etiology*; D003424:Crohn Disease / Q000601:surgery*; D017577:Cutaneous Fistula / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D064887:Observational Studies as Topic; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors
keywords: Crohn’s disease; postoperative intra-abdominal septic complications; risk factors