Identifying potential predictors of the risk of surgical site infection following cardiac surgery: a scoping review

Objectives: This scoping review was undertaken to identify risk prediction models and pre-operative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high risk of SSI, and therefore guide a national SSI prevention strategy. Methods: A scoping review to systematically identify and map out existing research evidence on pre-operative predictors of SSI was conducted in two stages. Stage 1 reviewed prediction modelling studies of SSI in cardiac surgery. Stage 2 identified primary studies and systematic reviews of novel cardiac SSI predictors. Results: The search identified 7887 unique reports; 7154 were excluded at abstract screening and 733 were selected for full-text assessment. Twenty-nine studies (across 30 reports) were included in Stage 1 and reported the development (N1/414), validation (N1/413), or both development and validation (N1/42) of 52 SSI risk prediction models including 67 different pre-operative predictors. The remaining 703 reports were reassessed in Stage 2; 49 studies met the inclusion criteria, and 56 novel pre-operative predictors that have not been assessed previously in models were identified.