Prognostic factors for mortality in invasive pneumococcal disease: a system review and meta-analysis

Abstract Risk factors associated with mortality in invasive pneumococcal disease remain unclear. The present work is a meta-analysis of studies that enrolled only patients with invasive pneumococcal disease and reported on mortality. Potentially eligible reports were identified from PubMed, CHAHL, and Web of Science, comprising 26 reports in total. Overall mortality for invasive pneumococcal disease was reported as 20.8% (95% confidence interval (CI) 17.5–24%). Factors associated with mortality were age (odds ratio (OR) 3.04, 95%CI 2.5–3.68), nursing home (OR 1.62, 95%CI 1.13–2.32), nosocomial infection (OR 2.10, 95%CI 1.52–2.89), septic shock (OR 13.35, 95%CI 4.54–39.31), underlying chronic diseases (OR 2.34, 95%CI 1.78–3.09), solid organ tumor (OR 5.34, 95%CI 2.07–13.74), immunosuppressed status (OR 1.67, 95%CI 1.31–2.14), and alcohol abuse (OR 3.14, 95%CI 2.13–4.64). Mortality rates with invasive pneumococcal disease remained high, and these findings may help clinicians provide appropriate initial treatment for this disease.Key points: The overall mortality rate from IPD has remained high, at 20.8% and older age, septic shock, immunosuppressed status, underlying chronic diseases, solid organ tumor, alcohol abuse, nursing home, and nosocomial infection were prognostic factors for mortality from IPD.

Download Full-text

Prognostic factors for mortality in invasive pneumococcal disease in adult: a system review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-91234-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hao Chen ◽

Hiromi Matsumoto ◽

Nobuyuki Horita ◽

Yu Hara ◽

Nobuaki Kobayashi ◽

...

Keyword(s):

Invasive Pneumococcal Disease ◽

Odds Ratio ◽

Pneumococcal Disease ◽

Web Of Science ◽

Meta Analysis ◽

Mortality Rates ◽

Solid Organ ◽

Factors Associated ◽

System Review ◽

Overall Mortality

AbstractRisk factors associated with mortality in invasive pneumococcal disease remain unclear. The present work is a meta-analysis of studies that enrolled only patients with invasive pneumococcal disease and reported on mortality. Potentially eligible reports were identified from PubMed, CHAHL, and Web of Science, comprising 26 reports in total. Overall mortality for invasive pneumococcal disease was reported as 20.8% (95% confidence interval (CI) 17.5–24%). Factors associated with mortality were age (odds ratio (OR) 3.04, 95% CI 2.5–3.68), nursing home (OR 1.62, 95% CI 1.13–2.32), nosocomial infection (OR 2.10, 95% CI 1.52–2.89), septic shock (OR 13.35, 95% CI 4.54–39.31), underlying chronic diseases (OR 2.34, 95% CI 1.78–3.09), solid organ tumor (OR 5.34, 95% CI 2.07–13.74), immunosuppressed status (OR 1.67, 95% CI 1.31–2.14), and alcohol abuse (OR 3.14, 95% CI 2.13–4.64). Mortality rates with invasive pneumococcal disease remained high, and these findings may help clinicians provide appropriate initial treatment for this disease.

Download Full-text

Pneumococcal Pneumonia and Invasive Pneumococcal Disease in Those 65 and Older: Rates of Detection, Risk Factors, Vaccine Effectiveness, Hospitalisation and Mortality

Geriatrics ◽

10.3390/geriatrics6010013 ◽

2021 ◽

Vol 6 (1) ◽

pp. 13

Author(s):

Roger E. Thomas

Keyword(s):

Risk Factors ◽

Nursing Home ◽

Invasive Pneumococcal Disease ◽

Disease Transmission ◽

Pneumococcal Disease ◽

Pneumococcal Pneumonia ◽

Clinical Symptoms ◽

Disease Incidence ◽

Family Members ◽

Vaccination Rates

Pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in seniors worldwide. Incidence rates and serious outcomes worsen with increasing frailty, numbers of risk factors and decreasing immune competence with increasing age. Literature reviews in Medline and Embase were performed for pneumococcal disease incidence, risk factors, vaccination rates and effectiveness in the elderly. The introduction of protein-conjugated pneumoccal vaccines (PCV) for children markedly reduced IPD and PP in seniors, but serotypes not included in vaccines and with previously low levels increased. Pneumococcal polysaccharide (PPV23) vaccination does not change nasal and pharyngeal carriage rates. Pneumococcal and influenza vaccination rates in seniors are below guideline levels, especially in older seniors and nursing home staff. Pneumococcal and influenza carriage and vaccination rates of family members, nursing home health care workers and other contacts are unknown. National vaccination programmes are effective in increasing vaccination rates. Detection of IPD and PP initially depend on clinical symptoms and new chest X ray infiltrates and then varies according to the population and laboratory tests used. To understand how seniors and especially older seniors acquire PP and IPD data are needed on pneumococcal disease and carriage rates in family members, carers and contacts. Nursing homes need reconfiguring into small units with air ventilation externally from all rooms to minimise respiratory disease transmission and dedicated staff for each unit to minimise transmision of infectious diseaases.

Download Full-text

Clinical Features and Risk Factors Associated with Recurrent Invasive Pneumococcal Disease in Indiana

American Journal of Infection Control ◽

10.1016/j.ajic.2016.04.156 ◽

2016 ◽

Vol 44 (6) ◽

pp. S134

Author(s):

Mugdha Golwalkar ◽

Amanda S. Billman

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Factors Associated

Download Full-text

Outcomes and prognostic factors of patients with anti-melanoma differentiation-associated protein 5 and anti-aminoacyl-RNA synthetase antibodies positive idiopathic inflammatory myopathies in intensive care unit

10.21203/rs.3.rs-50120/v1 ◽

2020 ◽

Author(s):

Shiyao Wang ◽

Xinran Zhang ◽

Yanhong Ren ◽

Yi Zhang ◽

Ye Tian ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Prognostic Factors ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Serum Ferritin ◽

Factors Associated ◽

Overall Mortality

Abstract Background: This study aims to identify prognostic factors for mortality of patients with anti-melanoma differentiation-associated protein 5 (anti-MDA5) or anti-aminoacyl-RNA synthetase (anti-ARS) antibodies positive and acute respiratory failure in the intensive care unit.Methods: Clinical characteristics, laboratory test findings, imaging performance, and management were retrospectively collected in all cases with anti-MDA5 and anti-ARS antibodies positive, as well as follow-up survival data. Risk factors related to prognosis were identified by Cox regression analysis.Results: The 28-day mortality of all patients was 68.8% (n=44/64). The patients who died were more likely to have anti-MDA5 antibody(p<0.001), presented more Gottron papules(p=0.021) or heliotrope rash(p=0.008), had a relatively lower level of WBC(p=0.038), CRP(p=0.004), and had a higher level of LDH(p=0.029), serum ferritin(p=0.002). The main risk factors associated with 28-day mortality were anti-MDA5 antibody positive [HR 10.827 (95% CI: 4.261-27.514), p<0.001], presence of Gottron papules [2.299 (1.203-4.394), p=0.012], heliotrope rash [3.423 (1.773-6.606), p<0.001], and arthritis/arthralgia [2.365 (1.130-4.948), p=0.022). At a median of 14 (IQR 6.33-35.0) months of follow-up, the overall mortality of all patients was 75.0% (n=48/64). The non-survivors were more likely to own anti-MDA5 antibody(p<0.001), had a higher rate of Gottron papules(p=0.020) or heliotrope rash(p=0.014), had lower PFR(p=0.032) while ICU admission, and existed a higher level of serum ferritin(p=0.005). Main risk factors associated with overall mortality were consistent with risk factors for 28-day mortality. Conclusions: Anti-MDA5 antibody positive, presence of Gottron papules, heliotrope rash, or arthritis/arthralgia were the main independent risk factors of poor prognosis for IIM patients admitted to the ICU due to acute respiratory failure.

Download Full-text

Effectiveness of pneumococcal conjugate vaccination against invasive pneumococcal disease among children with and those without HIV infection: a systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-019-4325-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Hossein Molavi Vardanjani ◽

Hodjat Borna ◽

Ali Ahmadi

Keyword(s):

Systematic Review ◽

Hiv Infection ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Meta Analysis ◽

Conjugate Vaccination

Download Full-text

Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis

The Korean Journal of Orthodontics ◽

10.4041/kjod.2016.46.2.111 ◽

2016 ◽

Vol 46 (2) ◽

pp. 111 ◽

Cited By ~ 17

Author(s):

Sung-Bin Hong ◽

Budi Kusnoto ◽

Eun-Jeong Kim ◽

Ellen A BeGole ◽

Hyeon-Shik Hwang ◽

...

Keyword(s):

Prognostic Factors ◽

Meta Analysis ◽

Success Rates ◽

Miniscrew Implants ◽

Factors Associated

Download Full-text

Increased risk of invasive pneumococcal disease in haematological and solid-organ malignancies

Epidemiology and Infection ◽

10.1017/s0950268810000919 ◽

2010 ◽

Vol 138 (12) ◽

pp. 1804-1810 ◽

Cited By ~ 46

Author(s):

A. WONG ◽

T. J. MARRIE ◽

S. GARG ◽

J. D. KELLNER ◽

G. J. TYRRELL ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Large Scale ◽

Adult Population ◽

Retrospective Chart Review ◽

Polysaccharide Vaccine ◽

Solid Organ ◽

Pneumococcal Polysaccharide Vaccine ◽

Increased Risk

SUMMARYLarge-scale population-based studies have reported a significant increase in invasive pneumococcal disease (IPD) in those with underlying haematological or solid-organ malignancy, but limited condition-specific data are available on rates of IPD in the adult population. A retrospective chart review of all patients with IPD (identified prospectively) in the province of Alberta, Canada (population ~3·3 million) was conducted from 2000 to 2004 to study the epidemiology of IPD. Rates of IPD in patients with various haematological and solid-organ malignancies were determined by obtaining the number of these patients at risk from the provincial cancer registry. Compared to the attack rate of IPD in the adult population aged ⩾18 years (11·0 cases/100 000 per year, 95% CI 10·44–11·65), there were significantly increased rates of IPD in those with lung cancer (143·6 cases/100 000 per year, OR 13·4, 95% CI 9·3–19·4, P<0·001) and multiple myeloma (673·9 cases/100 000 per year, OR 62·8, 95% CI 39·6–99·8, P<0·001). More modestly increased rates of IPD were found in those with chronic lymphocytic leukaemia, acute myeloid leukaemia, acute lymphoblastic leukaemia, and Hodgkin's and non-Hodgkin's lymphoma. There was an increased prevalence of serotype 6A in those with these underlying malignancies, but no other serotypes predominated. Fifty-three percent (48/83) of cases were caused by serotypes in the investigational 13-valent pneumococcal conjugate vaccine (PCV13), and 57/83 (69%) of the cases were caused by serotypes in the 23-valent pneumococcal polysaccharide vaccine (PPV23). The incidence of IPD in adults with certain haematological and solid-organ malignancies is significantly greater than the overall adult population. Such patients should be routinely given pneumococcal polysaccharide vaccine; this population could also be targeted for an expanded valency conjugate vaccine.

Download Full-text

Predictors of Post-Thrombotic Syndrome (PTS) in Pediatric Thrombosis: A Systematic Review and Meta-Analysis of the Literature

Blood ◽

10.1182/blood-2018-99-114999 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 3806-3806 ◽

Cited By ~ 1

Author(s):

Elissa Engel ◽

Manuela Albisetti ◽

Leonardo R. Brandao ◽

Ernest Amankwah ◽

Anthony Nguyen ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Prognostic Factors ◽

Prognostic Factor ◽

Cohort Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Factors Associated ◽

Post Thrombotic Syndrome ◽

Statistical Heterogeneity

Abstract BACKGROUND: Post-thrombotic syndrome (PTS) is the most common long-term complication in pediatric deep venous thrombosis (DVT), affecting approximately 25% of children with an extremity DVT. PTS leads to a high physical, psychological and financial burden in affected patients. Although several risk factors have been associated with the development of pediatric PTS, few of them have been validated in the pediatric literature. A better understanding of the prognostic factors leading to PTS is a vital step for early identification of those children at greatest risk in order to develop risk-stratified interventions aimed at preventing this complication. AIM: To perform a systematic review and meta-analysis of available published evidence from the pediatric literature on prognostic factors for pediatric PTS. METHODS: A systematic search of MEDLINE, EMBASE, and the Cochrane Library from 1960 to December 2017 was performed. MeSH terms and search strategy employed were as follows: "postthrombotic syndrome" OR "postphlebitic syndrome" AND "all child 0-18 years" AND "young adult 19-24 years". A study was eligible for inclusion if it evaluated the development of PTS in pediatric patients (<21 years of age) with a confirmed extremity DVT and reported on at least one prognostic factor for the development of PTS. Single case reports, narrative reviews, and commentaries were excluded. Studies assessing the efficacy/safety of thrombolysis, and studies including patients >21 years of age with outcomes not reported by age group, were also excluded. Two reviewers independently screened all studies and extracted the data of interest. Data were analyzed using STATA v.15 statistical software. Meta-analyses were conducted for risk factors reported in at least three studies. Summary odds ratios (ORs) and 95% confidence intervals (CI) were calculated from the effect estimates from the individual studies using a random effects model. Statistical heterogeneity was quantified by I2 statistic. RESULTS: A total of 12 studies met the final inclusion criteria (Figure 1), nine cohort studies, two cross-sectional studies, and one case-control study. These studies reported a total of 1,160 patients with venous thromboembolism (VTE), of whom 938 (81%) were assessed for PTS (Table 1). Median age across studies ranged from 0.02 - 15.5 years. VTE was considered provoked in nearly 80% of patients. The most common reported risk factor for VTE was the presence of a central venous catheter (CVC, 54%) followed by congenital heart disease (26%). PTS was diagnosed in 46% (n=434) of patients with an extremity DVT. The median time from DVT diagnosis to PTS diagnosis ranged from 12 to 33 months across studies. Among studies reporting this information, mild PTS was most frequently diagnosed, followed by moderate and severe PTS (35%, 5% and 0.6% of patients respectively). Most common prognostic factors associated with PTS in individual studies included patient characteristics: age and gender; and DVT characteristics: recurrent DVT, symptomatic DVT, DVT degree of occlusion, and time between DVT diagnosis and PTS assessment. Three studies investigated the association of elevated factor VIII and d-dimer levels with PTS. Elevated levels of these biomarkers were found to be associated with development of adverse VTE outcomes in one study but this finding was not confirmed in the other studies. Meta-analysis of reported prognostic factors identified the presence of a CVC and occlusive DVT as significant risk factors for the development of pediatric PTS (OR= 1.8, 95%CI=1.08-2.98, and OR=1.89, 95%CI=1.04-3.46 respectively; Figure 2). CONCLUSION: Among 12 studies evaluating prognostic factors for PTS in children and meeting criteria for this meta-analysis, CVC-related DVT and complete occlusion were associated with pediatric PTS. Overall, high-quality evidence on pediatric PTS is lacking. Collaborative prospective cohort studies and trials that use validated pediatric PTS measures and standardized prognostic factor definitions are needed to better understand the risk factors associated with PTS. Disclosures No relevant conflicts of interest to declare.

Download Full-text