The impact of surgical site infection on health utility values: a systematic review and meta-analysis

Citation

McFarland A (2024) The impact of surgical site infection on health utility values: a systematic review and meta-analysis. Unite Scientific Nursing Conference, Munich, Germany, 22.04.2024-23.04.2024.

Abstract
Surgical site infections (SSI) are recognised as negatively affecting patient quality of life. Quality of life is measured through utility which allows for the scope of this burden to be estimated and guide investment decisions in prevention efforts. Currently, no synthesised estimates of SSI utility values are available in the literature. This study aimed to address this gap. Using a systematic review methodology (PROSPERO registration CRD 42021262633), studies were included where quality of life data was gathered from adults undergoing surgery whereby quality of life data was presented as those with infection and those without at similar time points. Utility values were converted to a standard measure (EQ-5D). Meta-analyses were conducted using a random effects model across all relevant studies with subgroup analyses on SSI type and timing since surgery. 15 studies met the inclusion criteria with 2817 patients; six studies across seven time points were used for meta-analysis. The pooled mean difference in EQ-5D utility in all studies combined was – 0.08 (95% CI -0.11 - -0.05, I2 = 40%, prediction interval -0.16 to -0.01.). The mean difference in EQ-5D utility associated with Deep SSI was -0.10 (95%CI -0.14 - -0.06, I2 = 0.00%) and the mean difference in EQ-5D persisted over time. This study provided the first synthesised estimate of SSI burden over the short and long term. These give insight into the quality of life lost to these infections over time. The EQ-5D utility estimates for a range of SSI are also essential for infection prevention planning and future economic modelling.