The relationship between short-term mortality and quality of care for hip fracture: a meta-analysis of clinical pathways for hip fracture

Abstract Background The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, we aimed to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population. Methods We searched PubMed, EMBASE, and Cochrane library databases up to October 25, 2020. Randomized controlled trials (RCTs) were included if they focused on energy delivery guided by either IC or predictive equations in critically ill adults. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Short-term mortality was the primary outcome. The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity. Results Eight RCTs with 991 adults met the inclusion criteria. The overall quality of the included studies was moderate. Significantly higher mean energy delivered per day was observed in the IC group, as well as percent delivered energy over REE targets, than the control group. IC-guided energy delivery significantly reduced short-term mortality compared with the control group (risk ratio = 0.77; 95% CI 0.60 to 0.98; I2 = 3%, P = 0.03). IC-guided strategy did not significantly prolong the duration of mechanical ventilation (mean difference [MD] = 0.61 days; 95% CI − 1.08 to 2.29; P = 0.48), length of stay in ICU (MD = 0.32 days; 95% CI − 2.51 to 3.16; P = 0.82) and hospital (MD = 0.30 days; 95% CI − 3.23 to 3.83; P = 0.87). Additionally, adverse events were similar between the two groups. Conclusions This meta-analysis indicates that IC-guided energy delivery significantly reduces short-term mortality in critically ill patients. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.

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Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis

Heart ◽

10.1136/heartjnl-2017-312517 ◽

2018 ◽

Vol 104 (16) ◽

pp. 1362-1369 ◽

Cited By ~ 20

Author(s):

Chee Yoong Foo ◽

Kwadwo Osei Bonsu ◽

Brahmajee K Nallamothu ◽

Christopher M Reid ◽

Teerapon Dhippayom ◽

...

Keyword(s):

Myocardial Infarction ◽

Meta Analysis ◽

Coronary Intervention ◽

Short Term ◽

Percutaneous Coronary ◽

Short Term Mortality ◽

St Elevation ◽

Door To Balloon ◽

Prehospital Delays ◽

The Relationship

ObjectiveThis study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers.MethodsWe conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure.Results32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time–risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran’s Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays.ConclusionLonger door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time–risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA.Clinical trial registrationPROSPERO (CRD42015026069).

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Energy Delivery Guided by Indirect Calorimetry in Critically Ill Patients: a Systematic Review and Meta-analysis

10.21203/rs.3.rs-125406/v1 ◽

2020 ◽

Author(s):

Jing-Yi Duan ◽

Wen-He Zheng ◽

Hua Zhou ◽

Yuan Xu ◽

Hui-bin Huang

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Meta Analysis ◽

Control Group ◽

Short Term ◽

Predictive Equations ◽

Energy Delivery ◽

Effect Model ◽

Short Term Mortality

Abstract Background: The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, we aimed to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population.Methods: We searched PubMed, EMBASE, and Cochrane library databases up to Oct 25, 2020. Randomized controlled trials (RCTs) were included if they focused on energy delivery guided by either IC or predictive equations in critically ill adults. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Short-term mortality was the primary outcome. The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity. Results: Eight RCTs with 991 adults met the inclusion criteria. The overall quality of the included studies was moderate. Significantly higher mean energy delivered per day was observed in the IC group, as well as percent delivered energy over REE targets, than the control group. IC-guided energy delivery significantly reduced short-term mortality compared with the control group (risk ratio=0.77; 95% CI, 0.60 to 0.98; I2=3%, P=0.03). IC-guided strategy did not significantly prolong the duration of mechanical ventilation (mean difference [MD]=0.61 days; 95% CI, -1.08 to 2.29; P=0.48), length of stay in ICU (MD=0.32 days; 95% CI, -2.51 to 3.16; P=0.82) and hospital (MD=0.30 days; 95% CI, -3.23 to 3.83; P=0.87). Additionally, adverse events were similar between the two groups. Conclusions: This meta-analysis indicates that IC-guided energy delivery significantly reduces short-term mortality in critically ill patients. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.

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Corrigendum to ‘Impact of health-related quality of life (HRQoL) on short-term mortality in patients with recurrent ovarian, fallopian or peritoneal carcinoma (the NOGGO-AGO QoL Prognosis-Score-Study): results of a meta-analysis in 2209 patients’

ESMO Open ◽

10.1016/j.esmoop.2021.100176 ◽

2021 ◽

pp. 100176

Author(s):

R. Richter ◽

R. Armbrust ◽

H. Woopen ◽

F. Hilpert ◽

P. Harter ◽

...

Keyword(s):

Meta Analysis ◽

Peritoneal Carcinoma ◽

Short Term ◽

Score Study ◽

Study Results ◽

Short Term Mortality ◽

Related Quality ◽

Health Related ◽

Prognosis Score

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Older patients with acute stroke in Denmark: quality of care and short-term mortality. A nationwide follow-up study

Age and Ageing ◽

10.1093/ageing/afm134 ◽

2007 ◽

Vol 37 (1) ◽

pp. 90-95 ◽

Cited By ~ 57

Author(s):

K. D. Palnum ◽

P. Petersen ◽

H. T. Sorensen ◽

A. Ingeman ◽

J. Mainz ◽

...

Keyword(s):

Quality Of Care ◽

Acute Stroke ◽

Older Patients ◽

Short Term ◽

Follow Up Study ◽

Short Term Mortality

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Prognostic value of HbA1c for in-hospital and short-term mortality in patients with acute coronary syndrome: a systematic review and meta-analysis

Cardiovascular Diabetology ◽

10.1186/s12933-019-0970-6 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 5

Author(s):

Wenjun Pan ◽

Haining Lu ◽

Baotao Lian ◽

Pengda Liao ◽

Liheng Guo ◽

...

Keyword(s):

Systematic Review ◽

Acute Coronary Syndrome ◽

Hospital Mortality ◽

Meta Analysis ◽

Hospital Death ◽

Short Term ◽

Coronary Syndrome ◽

Relative Risks ◽

Short Term Mortality ◽

The Relationship

Abstract Background HbA1c, the most commonly used indicator of chronic glucose metabolism, is closely associated with cardiovascular disease. However, the relationship between HbA1c and the mortality of acute coronary syndrome (ACS) patients has not been elucidated yet. Here, we aim to conduct a systematic review assessing the effect of HbA1c on in-hospital and short-term mortality in ACS patients. Methods Relevant studies reported before July 2019 were retrieved from databases including PubMed, Embase, and Central. Pooled relative risks (RRs) and the corresponding 95% confidence interval (CI) were calculated to evaluate the predictive value of HbA1c for the in-hospital mortality and short-term mortality. Results Data from 25 studies involving 304,253 ACS patients was included in systematic review. The pooled RR of in-hospital mortality was 1.246 (95% CI 1.113–1.396, p: 0.000, I2 = 48.6%, n = 14) after sensitivity analysis in studies reporting HbA1c as categorial valuable. The pooled RR was 1.042 (95% CI 0.904–1.202, p: 0.57, I2 = 82.7%, n = 4) in random-effects model for studies reporting it as continuous valuable. Subgroup analysis by diabetic status showed that elevated HbA1c is associated increased short-term mortality in ACS patients without diabetes mellitus (DM) history and without DM (RR: 2.31, 95% CI (1.81–2.94), p = 0.000, I2 = 0.0%, n = 5; RR: 2.56, 95% CI 1.38–4.74, p = 0.003, I2 = 0.0%, n = 2, respectively), which was not the case for patients with DM and patients from studies incorporating DM and non-DM individuals (RR: 1.16, 95% CI 0.79–1.69, p = 0.451, I2 = 31.9%, n = 3; RR: 1.10, 95% CI 0.51–2.38), p = 0.809, I2 = 47.4%, n = 4, respectively). Conclusions Higher HbA1c is a potential indicator for in-hospital death in ACS patients as well as a predictor for short-term mortality in ACS patients without known DM and without DM.

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