Abstract
BackgroundMetabolic syndrome (MetS) is defined as an accumulation of risk factors that include chronic hypertension, dyslipidaemia, insulin resistance and obesity and leads to an increased risk for diabetes, cardiovascular disease and stroke. MetS is widespread and estimated to affect up to a quarter of the global population. Patients with MetS who undergo surgery are associated with an increased risk of postoperative complications when compared with patients with a non-MetS profile. An emerging body of literature points to MetS being associated with a greater risk of postoperative pulmonary complications (PPC) in the surgical patient. PPC are associated with increased postoperative morbidity and mortality, Intensive care unit (ICU) admission, length of stay (ICU and hospital), health care costs, resource usage, unplanned re-intubation and prolonged ventilatory time.Methods/designWe will search for relevant studies in the following electronic bibliographic databases: EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus as well as scan the reference lists of included studies for potential additional literature. Two authors will independently screen titles and abstracts to identify potentially relevant studies for inclusion based on predefined inclusion and exclusion criteria. The Cochrane Collaboration Review Manager (Review Manager 5) statistical software will be used to conduct this systematic review and meta-analysis and generate forest plots to demonstrate comparison of findings across studies included for meta-analysis. Subgroup and sensitivity analysis will be performed to assess the heterogeneity of included studies. A descriptive synthesis of the statistical data will be provided to summarise the results and findings of the systematic review and meta-analysis.DiscussionThis review will be the first to report and summarise the risk for and incidence of PPC in adult patients with MetS undergoing surgery across a range of surgical specialities. The results have the potential to inform the development of evidenced-based interventions to improve the management of PPC in the surgical patient with MetS. Findings from this systematic review and meta-analysis will inform a subsequent Delphi study on priorities and responses to PPC in patients with MetS. We will also disseminate our results through publication in scientific peer-reviewed journals, conference presentations and promotion throughout our network of surgical safety champions in clinical settings.Systematic review registrationPROSPERO CRD42019120279.
Highlights
Metabolic syndrome (MetS) is defined as an accumulation of risk factors that include chronic hypertension, dyslipidaemia, insulin resistance and obesity and leads to an increased risk for diabetes, cardiovascular disease and stroke
The results have the potential to inform the development of evidenced-based interventions to improve the management of pulmonary complications (PPC) in the surgical patient with MetS
To overcome the difficulties associated with multiple definitions of MetS, leading health organisations produced a Joint Interim Statement (JIS) to harmonise diagnostic criteria and components of MetS into a unified, widely accepted, and broadly adopted definition as outline in Table 1 [6]
Summary
Metabolic syndrome (MetS) is defined as an accumulation of risk factors that include chronic hypertension, dyslipidaemia, insulin resistance and obesity and leads to an increased risk for diabetes, cardiovascular disease and stroke. Metabolic syndrome (MetS) is a global health problem which leads to an increased risk of cardiovascular disease, stroke, non-insulin dependent diabetes mellitus and premature death [1]. An individual is diagnosed with MetS when at least three out of five of these components are present [4, 5] These components vary slightly according to the definition of MetS used. To overcome the difficulties associated with multiple definitions of MetS, leading health organisations produced a Joint Interim Statement (JIS) to harmonise diagnostic criteria and components of MetS into a unified, widely accepted, and broadly adopted definition as outline in Table 1 [6]
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