{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:35:14Z","timestamp":1793392514787,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,22]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Surgical site infections (SSI) after hysterectomy constitute significant postoperative complications, affecting patient recovery and healthcare costs. We conducted a systematic review of risk factors for SSI in patients undergoing hysterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The current study conducted a systematic review with meta-analysis to identify and summarise risk factors for SSI following hysterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials were searched through 1 November 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>The inclusion criteria were (1) population: female participants who had post-hysterectomy SSI; (2) intervention: hysterectomy surgeries; (3) comparators: the number of participants who had or had not post-hysterectomy SSI; (4) outcomes: the number of participants exposed and not exposed to the risk factors of SSI. The exclusion criteria were (1) non-English studies and (2) studies that provided insufficient data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two reviewers conducted the screening process independently. Articles that did not meet the inclusion criteria were excluded. For those that met the criteria, full-text papers were procured. Any discrepancies between the reviewers were resolved through discussion. The meta-analysis synthesised risk factors reported in \u22654 datasets via random-effects models, assessing heterogeneity, sensitivity (leave-one-out), publication bias (Egger\u2019s test\/funnel plots) and subgroup analyses (incision types).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Blood transfusion emerged as the largest risk factor (OR=2.55, 95%\u2009CI (1.84, 3.56)), followed by tumour presence (OR=2.23, 95%\u2009CI (1.86, 2.66)), obesity (OR=1.79, 95%\u2009CI (1.43, 2.23)), diabetes (OR=1.70, 95%\u2009CI (1.26, 2.29)) and tobacco use (OR=1.43, 95%\u2009CI (1.26, 1.63)). The ORs varied by incision type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study establishes blood transfusion, tumour presence, obesity, diabetes and tobacco use as significant risk factors for SSI after hysterectomy, with variations in risk evident across different incision types. The findings also suggest vaginal and laparoscopic hysterectomies as preferable alternatives to abdominal hysterectomy in mitigating SSI risk. Future research should aim for more granular data to untangle the interplay between comorbidities and further elucidate the differential risk across SSI types.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093072","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T15:25:20Z","timestamp":1749050720000},"page":"e093072","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Risk factors for surgical site infection (SSI) in patients undergoing hysterectomy: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"15","author":[{"given":"Yin","family":"Liu","sequence":"first","affiliation":[{"name":"Nosocomial Infection Management Department, West China Women's and Children\u2019s Hospital, Chengdu, Sichuan, China"},{"name":"Sichuan University West China Second University Hospital Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Liu","sequence":"additional","affiliation":[{"name":"Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China"},{"name":"Department of Social Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8292-0324","authenticated-orcid":false,"given":"Zhan","family":"Yang","sequence":"additional","affiliation":[{"name":"Sichuan University West China Second University Hospital Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu, Sichuan, China"},{"name":"Medical Affairs Department, West China Women's and Children\u2019s Hospital, Chengdu, Sichuan, China"},{"name":"Medical and Education Department, WCSUH-Tianfu\u00b7Sichuan Provincial Children\u2019s Hospital, Meishan, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlin","family":"Wu","sequence":"additional","affiliation":[{"name":"Medical Affairs Department, West China Women's and Children\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Li","sequence":"additional","affiliation":[{"name":"Nosocomial Infection Management Department, West China Women's and Children\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"2025121512405491000_15.6.e093072.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.186"},{"key":"2025121512405491000_15.6.e093072.2","doi-asserted-by":"publisher","DOI":"10.4103\/0976-7800.109635"},{"key":"2025121512405491000_15.6.e093072.3","unstructured":"OECD . 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