Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational cohort studies.
PubMed 37916943 · doi:10.1097/JS9.0000000000000834
What was done
A systematic review and meta-analysis following PRISMA and AMSTAR guidelines evaluating the association between metabolic syndrome and postoperative complications. The study pooled data from 63 studies encompassing 1,919,347 patients with metabolic syndrome and 11,248,114 without.
What was found
Compared to patients without metabolic syndrome, individuals with the condition had significantly higher risks across multiple postoperative outcomes: - Mortality: OR 1.75 (95% CI: 1.36-2.24; P < 0.01) - Surgical site infections and dehiscence: OR 1.64 (95% CI: 1.52-1.77; P < 0.01) - Cardiovascular complications: OR 1.56 (95% CI: 1.41-1.73; P < 0.01) - Readmission: OR 1.55 (95% CI: 1.41-1.71; P < 0.01) - Length of hospital stay: Mean Difference 0.65 days (95% CI: 0.39-0.9; P < 0.01)
Why it matters
With metabolic syndrome affecting an estimated 46% of surgical patients, these findings confirm that the syndrome independently compounds perioperative morbidity and mortality, underscoring the need for structured perioperative screening and intervention pathways.
Limits
The included studies are observational and inherently subject to residual confounding. The abstract does not report heterogeneity statistics, specific definitions of metabolic syndrome used across primary studies, or stratification by surgical specialty and urgency.
Cited by
- supports Patients who are significantly overweight have a higher risk of surgical healing complications, including abscesses, wound necrosis, and infection.