Head Games: A Systematic Review and Meta-analysis Examining Concussion and Head Impact Incidence Rates, Modifiable Risk Factors, and Prevention Strategies in Youth Tackle Football

Abstract Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China

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P62 RISK FACTORS AND OUTCOMES ASSOCIATED WITH ANASTOMOTIC LEAKS (AL) FOLLOWING OESOPHAGECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Diseases of the Esophagus ◽

10.1093/dote/doz092.62 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

K Kamarajah Sivesh ◽

Lin Aaron ◽

Tharmaraja Thahesh ◽

Bharwada Yashvi ◽

R Bundred James ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Major Complication ◽

Adverse Outcomes ◽

Cardiac Complications ◽

Modifiable Risk Factors ◽

Anastomotic Leaks ◽

Patient Counselling ◽

Prolonged Hospital

Abstract Introduction Anastomotic leaks (AL) are a major complication after oesophagectomy. This meta-analysis aimed to determine identify risks factors for AL (pre-operative, intra-operative and post-operative factors) and assess the consequences to outcome on patients who developed an AL. Methods This systematic review was performed according to PRISMA guidelines and eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 31st December 2018. A meta-analysis was conducted with the use of random-effects modelling and prospectively registered with the PROSPERO database (Registration CRD42018130732). Results This review identified 174 studies reporting outcomes of 74,226 patients undergoing oesophagectomy. The overall pooled AL rates were 11%, ranging from 0 - 49% in individual studies. Majority of studies were from Asia (n=79). In pooled analyses, 23 factors were associated with AL (17 preoperative and six intraoperative). AL were associated with adverse outcomes including pulmonary (OR: 4.54, CI95%: 2.99 - 6.89, p<0.001) and cardiac complications (OR: 2.44, CI95%: 1.77 - 3.37, p<0.001), prolonged hospital stay (mean difference: 15 days, CI95%: 10 - 21 days, p<0.001 and in-hospital mortality (OR: 5.91, CI95%: 1.41 - 24.79, p=0.015). Conclusion AL are a major complication following oesophagectomy accounting for major morbidity and mortality. This meta-analysis identified modifiable risk factors for AL which can be a target for interventions to reduce anastomotic leak rates. Furthermore, identification of both modifiable and non-modifiable risk factors will facilitate risk stratification and prediction of AL enabling better perioperative planning, patient counselling and informed consent.

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Risk factors and outcomes associated with anastomotic leaks following esophagectomy: a systematic review and meta-analysis

Diseases of the Esophagus ◽

10.1093/dote/doz089 ◽

2020 ◽

Vol 33 (3) ◽

Cited By ~ 3

Author(s):

Sivesh K Kamarajah ◽

Aaron Lin ◽

Thahesh Tharmaraja ◽

Yashvi Bharwada ◽

James R Bundred ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Major Complication ◽

Adverse Outcomes ◽

Cardiac Complications ◽

Modifiable Risk Factors ◽

Anastomotic Leaks ◽

Patient Counseling ◽

Prolonged Hospital

Summary Anastomotic leaks (AL) are a major complication after esophagectomy. This meta-analysis aimed to determine identify risks factors for AL (preoperative, intra-operative, and post-operative factors) and assess the consequences to outcome on patients who developed an AL. This systematic review was performed according to PRISMA guidelines, and eligible studies were identified through a search of PubMed, Scopus, and Cochrane CENTRAL databases up to 31 December 2018. A meta-analysis was conducted with the use of random-effects modeling and prospectively registered with the PROSPERO database (Registration CRD42018130732). This review identified 174 studies reporting outcomes of 74,226 patients undergoing esophagectomy. The overall pooled AL rates were 11%, ranging from 0 to 49% in individual studies. Majority of studies were from Asia (n = 79). In pooled analyses, 23 factors were associated with AL (17 preoperative and six intraoperative). AL were associated with adverse outcomes including pulmonary (OR: 4.54, CI95%: 2.99–6.89, P < 0.001) and cardiac complications (OR: 2.44, CI95%: 1.77–3.37, P < 0.001), prolonged hospital stay (mean difference: 15 days, CI95%: 10–21 days, P < 0.001), and in-hospital mortality (OR: 5.91, CI95%: 1.41–24.79, P = 0.015). AL are a major complication following esophagectomy accounting for major morbidity and mortality. This meta-analysis identified modifiable risk factors for AL, which can be a target for interventions to reduce AL rates. Furthermore, identification of both modifiable and non-modifiable risk factors will facilitate risk stratification and prediction of AL enabling better perioperative planning, patient counseling, and informed consent.

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Incidence rates, risk factors, and outcomes of aspiration pneumonia after gastric endoscopic submucosal dissection: A systematic review and meta‐analysis

Journal of Gastroenterology and Hepatology ◽

10.1111/jgh.15359 ◽

2021 ◽

Author(s):

Dong Tang ◽

Fuxiang Yuan ◽

Xiaoying Ma ◽

Haixia Qu ◽

Yuan Li ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Endoscopic Submucosal Dissection ◽

Aspiration Pneumonia ◽

Meta Analysis ◽

Incidence Rates ◽

Submucosal Dissection

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Individually modifiable risk factors to ameliorate cognitive aging: a systematic review and meta-analysis

Climacteric ◽

10.3109/13697137.2015.1078106 ◽

2015 ◽

Vol 18 (5) ◽

pp. 678-689 ◽

Cited By ~ 38

Author(s):

P. Lehert ◽

P. Villaseca ◽

E. Hogervorst ◽

P. M. Maki ◽

V. W. Henderson

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cognitive Aging ◽

Meta Analysis ◽

Modifiable Risk Factors

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Modifiable risk factors of acute kidney injury after liver transplantation: a systematic review and meta-analysis

BMC Nephrology ◽

10.1186/s12882-021-02360-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jian Zhou ◽

Xueying Zhang ◽

Lin Lyu ◽

Xiaojun Ma ◽

Guishen Miao ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Protective Factor ◽

Calcineurin Inhibitor ◽

Meta Analysis ◽

Random Effect Model ◽

Kidney Injury ◽

Modifiable Risk Factors

Abstract Background Acute kidney injury (AKI) is a common and critical complication of liver transplantation (LT), which is associated with increased morbidity, mortality and health care cost. We aimed to identify modifiable risk factors of AKI after LT. Methods A literature search of Pubmed, EMBASE and Cochrane Databases was performed to identify studies investigating risk factors of AKI after LT. The Newcastle-Ottawa Scale was used to rate study quality. Effect size and 95% confidence interval were pooled using a random-effect model with inverse-variance method. Results Sixty-seven articles with 28,844 patients were included in the meta-analysis. Seventeen modifiable risk factors were found, including overweight, preoperative use of diuretic, preoperative anemia, donation after cardiac death organ, donor BMI ≥ 30 kg/m2, ABO-incompatible LT, low graft to recipient body weight ratio, intraoperative hypotension, major bleeding, intraoperative use of vasopressor, large RBC transfusion, postreperfusion syndrome, postoperative use of vasopressors, overexposure to calcineurin inhibitor, calcineurin inhibitor without mycophenolate mofetil, graft dysfunction and infection. A total of 38 articles were included in the systematic review, in which 8 modifiable risk factors and 1 protective factor were additionally associated in single studies with the incidence of AKI after LT. Conclusions Effective interventions based on identified modifiable risk factors in the perioperative management and graft allocation and preservation may be promising to reduce the incidence of AKI after LT. Trial registration The protocol for this systematic review is registered with PROSPERO (No. CRD42020166918).

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Modifiable risk factors for patellar tendinopathy in athletes: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-099000 ◽

2018 ◽

Vol 52 (24) ◽

pp. 1575-1585 ◽

Cited By ~ 8

Author(s):

Andrew L Sprague ◽

Angela H Smith ◽

Patrick Knox ◽

Ryan T Pohlig ◽

Karin Grävare Silbernagel

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Strong Evidence ◽

Associated Factors ◽

Meta Analysis ◽

Patellar Tendinopathy ◽

Original Research ◽

Modifiable Risk Factors ◽

Cross Sectional ◽

Modifiable Factors

ObjectiveTo perform a systematic review and meta-analysis identifying (1) potential modifiable risk factors and (2) associated modifiable factors for patellar tendinopathy in athletes.DesignA systematic review and meta-analysis was conducted. Risk of bias was assessed using the Newcastle-Ottawa Scale and grouped based on study design. Meta-analytic statistics were performed for items reported by five or more studies. A strength of evidence rating is provided for items not appropriate for meta-analysis.Data sourcesPubMed, Web of Science, Scopus and Cinahl were searched on 14 November 2017.Eligibility criteriaQuantitative, original research reporting potential modifiable risk factors or associated factors, comparing athletes with patellar tendinopathy with a group without the injury.Results862 records were screened and 31 articles were included (6 prospective, 25 cross-sectional). There was a lack of strong evidence for any potential modifiable risk factor or associated factors. There was limited or conflicting evidence that decreased ankle dorsiflexion range of motion, decreased posterior thigh and quadriceps flexibility, greater volume of jump training, more volleyball sets played per week, greater countermovement jump (CMJ) height and greater activity volume are potential modifiable risk factors. Meta-analysis supported greater activity volume (Cohen’s d=0.22, 95% CI 0.06 to 0.39, p=0.008), higher body weight (0.36, 0.17 to 0.55, p<0.001) and greater CMJ height (0.31, 0.07 to 0.56, p=0.01) as associated modifiable factors.ConclusionsThere is a lack of strong evidence for any potential modifiable risk factors or associated factors. Factors with lower levels of support may be of interest in designing prevention programmes but require further research in high-quality, prospective studies.

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Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

Palliative Medicine ◽

10.1177/02692163211065278 ◽

2021 ◽

pp. 026921632110652

Author(s):

Imogen Featherstone ◽

Trevor Sheldon ◽

Miriam Johnson ◽

Rebecca Woodhouse ◽

Jason W Boland ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Palliative Care ◽

Meta Analysis ◽

Performance Status ◽

Univariate Analysis ◽

Adult Patients ◽

Modifiable Risk Factors ◽

Specialist Palliative Care ◽

Context Specific

Background: Delirium is common and distressing for patients receiving palliative care. Interventions targetting modifiable risk factors in other settings have been shown to prevent delirium. Research on delirium risk factors in palliative care can inform context-specific risk-reduction interventions. Aim: To investigate risk factors for the development of delirium in adult patients receiving specialist palliative care. Design: Systematic review and meta-analysis (PROSPERO CRD42019157168). Data sources: CINAHL, Cochrane Database of Systematic Reviews, Embase, MEDLINE and PsycINFO (1980-2021) were searched for studies reporting the association of risk factors with delirium incidence/prevalence for patients receiving specialist palliative care. Study risk of bias and certainty of evidence for each risk factor were assessed. Results: Of 28 included studies, 16 conducted only univariate analysis, 12 conducted multivariate analysis. The evidence for delirium risk factors was limited with low to very low certainty. Potentially modifiable risk factors: Opioids and lower performance status were positively associated with delirium, with some evidence also for dehydration, hypoxaemia, sleep disturbance, liver dysfunction and infection. Mixed, or very limited, evidence was found for some factors targetted in multicomponent prevention interventions: sensory impairments, mobility, catheter use, polypharmacy (single study), pain, constipation, nutrition (mixed evidence). Non-modifiable risk factors: Older age, male sex, primary brain cancer or brain metastases and lung cancer were positively associated with delirium. Conclusions: Findings may usefully inform interventions to reduce delirium risk but more high quality prospective cohort studies are required to enable greater certainty about associations of different risk factors with delirium during specialist palliative care.

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