Summary of findings 4. Risk of postoperative infectious complications: anti‐TNF agents compared to control.
| Anti‐TNF‐α agents compared to control in inflammatory bowel disease | |||||
| Patient or population: inflammatory bowel disease Setting: Intervention: Anti‐TNF‐α agents Comparison: control | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with control | Risk with Anti‐TNF‐α agents | ||||
| Overall infectious complications within 30 days of surgery | Study population | OR 1.27 (1.09 to 1.47) | 54 observational studies | ⊕⊝⊝⊝ VERY LOW 1 2 3 | |
| 112 per 1,000 | 138 per 1,000 (121 to 156) | ||||
| Overall infectious complications within 30 days of surgery (Adjusted Analysis) | Study population | OR 1.60 (1.20 to 2.13) | 17 observational studies | ⊕⊝⊝⊝ VERY LOW 3 | |
| 112 per 1,000 | 167 per 1,000 (131 to 211) | ||||
| Overall infectious complications within 30 days of surgery (Unadjusted Analysis) | Study population | OR 1.14 (0.96 to 1.36) | 37 observational studies | ⊕⊝⊝⊝ VERY LOW 2 3 4 5 | |
| 112 per 1,000 | 125 per 1,000 (108 to 146) | ||||
| Incisional infections and wound dehiscence within 30 days of surgery | Study population | OR 1.18 (0.83 to 1.68) | 24 observational studies | ⊕⊝⊝⊝ VERY LOW 1 2 3 | |
| 45 per 1,000 | 53 per 1,000 (38 to 74) | ||||
| Intra‐abdominal infectious complications within 30 days of surgery | Study population | OR 1.38 (1.04 to 1.82) | 39 observational studies | ⊕⊝⊝⊝ VERY LOW 1 3 6 | |
| 66 per 1,000 | 89 per 1,000 (69 to 115) | ||||
| Extra‐abdominal infections within 30 days of surgery | Study population | OR 1.34 (0.96 to 1.87) | 13 observational studies | ⊕⊝⊝⊝ VERY LOW 1 3 | |
| 13 per 1,000 | 18 per 1,000 (13 to 25) | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Many studies did not perform adjusted analyses and were considered to have a high risk of bias according to the Newcastle Ottawa Scale
2 Many confidence intervals do not overlap
3 Wide confidence interval
4 Many studies did not performed adjusted analyses and were considered to have a high risk of bias according to the Newcastle Ottawa Scale
5 Studies did not perform adjusted analyses and were considered to have a high risk of bias according to the Newcastle Ottawa Scale
6 High degree of heterogeneity