Does metabolic syndrome predict surgical complications? A protocol for a systematic review and meta-analysis

Norris, Philip and Ralph, Nicholas and Moloney, Clint (2017) Does metabolic syndrome predict surgical complications? A protocol for a systematic review and meta-analysis. Systematic Reviews, 6 (1).

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Background: Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular
disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations. Surgical patients with MetS are at significantly higher risk of a range of adverse outcomes including death, morbid cardiovascular events, coma,
stroke, renal failure, myocardial infarction, and surgical site infections. Increased complication rates result in
prolonged hospital stays, a greater need for post-hospitalisation care, and reduced effectiveness of surgical

Methods/design: We will search the following electronic bibliographic databases: MEDLINE, EMBASE, ScienceDirect,
and CINAHL, and the reference lists of included articles. We will also search for unpublished literature. Two authors
will screen titles and abstract information independently and select studies according to established inclusion and
exclusion criteria. Data will be extracted by the study investigators using Review Manager 5 and will include
information on demographics, incidence, prevalence, and outcome variables. Subgroup analysis and sensitivity
analysis will be performed to assess the heterogeneity of included studies. Meta-analysis will also be carried out if
appropriate study groups are identified. A descriptive narrative for statistical data will also be provided to highlight findings of the systematic review and meta-analysis.

Discussion: This study will report and summarise adverse outcomes among adult patients with MetS undergoing
surgery across a range of surgical specialties. Developing insights into outcomes of this population of interest is
necessary to develop guidelines towards better management of surgical patients with metabolic syndrome.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Nursing and Midwifery
Date Deposited: 20 Sep 2017 00:53
Last Modified: 09 May 2018 01:35
Uncontrolled Keywords: metabolic syndrome, surgery, safety, risk, prevalence, complications, adverse events
Fields of Research : 11 Medical and Health Sciences > 1103 Clinical Sciences > 110323 Surgery
Socio-Economic Objective: C Society > 92 Health > 9202 Health and Support Services > 920209 Mental Health Services
Identification Number or DOI: 10.1186/s13643-017-0515-6

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