289: Customized approach to fetal growth better identifies neonates at risk of adverse outcomes compared to population norms: a Bayesian network meta-analysis of observational studies

PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

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Metabolomics for predicting fetal growth restriction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022743 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022743 ◽

Cited By ~ 4

Author(s):

Debora Farias Batista Leite ◽

Aude-Claire Morillon ◽

Elias F Melo Júnior ◽

Renato T Souza ◽

Ali S Khashan ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Case Reports ◽

Meta Analysis ◽

Adverse Outcomes ◽

Growth Restriction ◽

Sample Collection

IntroductionFetal growth restriction (FGR) is a relevant research and clinical concern since it is related to higher risks of adverse outcomes at any period of life. Current predictive tools in pregnancy (clinical factors, ultrasound scan, placenta-related biomarkers) fail to identify the true growth-restricted fetus. However, technologies based on metabolomics have generated interesting findings and seem promising. In this systematic review, we will address diagnostic accuracy of metabolomics analyses in predicting FGR.Methods and analysisOur primary outcome is small for gestational age infant, as a surrogate for FGR, defined as birth weight below the 10th centile by customised or population-based curves for gestational age. A detailed systematic literature search will be carried in electronic databases and conference abstracts, using the keywords ‘fetal growth retardation’, ‘metabolomics’, ‘pregnancy’ and ‘screening’ (and their variations). We will include original peer-reviewed articles published from 1998 to 2018, involving pregnancies of fetuses without congenital malformations; sample collection must have been performed before clinical recognition of growth impairment. If additional information is required, authors will be contacted. Reviews, case reports, cross-sectional studies, non-human research and commentaries papers will be excluded. Sample characteristics and the diagnostic accuracy data will be retrieved and analysed. If data allows, we will perform a meta-analysis.Ethics and disseminationAs this is a systematic review, no ethical approval is necessary. This protocol will be publicised in our institutional websites and results will be submitted for publication in a peer-reviewed journal.PROSPERO registration numberCRD42018089985.

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Polypharmacy and Hyperpolypharmacy in Older Individuals with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Gerontology ◽

10.1159/000521214 ◽

2022 ◽

pp. 1-10

Author(s):

Akshaya Srikanth Bhagavathula ◽

Wubshet Tesfaye ◽

Kota Vidyasagar ◽

Daniela Fialova

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Observational Studies ◽

Meta Analysis ◽

Adverse Outcomes ◽

Older Individuals ◽

Drug Related Problems ◽

Inclusion Criteria ◽

Pooled Prevalence

Background and Aim: Polypharmacy (concomitant use of 5–9 medicines) and hyperpolypharmacy (concomitant use of over 10 medicines) were observed to be more frequent in older adults (≥65 years) and associated with adverse outcomes. Their prevalence and risk in older patients with Parkinson’s disease (PD) remain unknown. We aimed to synthesize the extant evidence on the prevalence and risk of polypharmacy and hyperpolypharmacy in older adults with PD. Methods: A systematic literature search was performed in PubMed/MEDLINE, Scopus, and Embase databases to identify pertinent studies published from 2000 to July 2021. Observational studies reporting the prevalence and association with disease of polypharmacy/hyperpolypharmacy in older adults with PD were meta-analyzed. Pooled prevalence and odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Results: Out of the total 499 studies identified, 6 fulfilled the inclusion criteria and comprised 7,171 participants. The overall prevalence of polypharmacy and hyperpolypharmacy was 40% (95% CI: 37–44) and 18% (95% CI: 13–23), respectively. A meta-analysis of 4 studies indicated a significant association between polypharmacy (OR: 1.94, 95% CI: 1.26–2.62; p < 0.001) and PD. Hyperpolypharmacy was also strongly associated with PD (OR: 3.11, 95% CI: 2.08–4.14; p < 0.001). Conclusion: Polypharmacy (40%) and hyperpolypharmacy (18%) are highly prevalent and eventually increase the risk of drug-related problems in older adults with PD. Therefore, interventions that ensure rational geriatric pharmacotherapy are of critical importance for the older population with neurogenerative disorders.

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Lack of consistent associations between pharmacological gastric acid suppression and adverse outcomes in patients with COVID-19: meta-analysis of observational studies.

Gastroenterology ◽

10.1053/j.gastro.2021.02.028 ◽

2021 ◽

Author(s):

Faisal Kamal ◽

Muhammad Ali Khan ◽

Sachit Sharma ◽

Zaid Imam ◽

Colin W. Howden

Keyword(s):

Gastric Acid ◽

Observational Studies ◽

Meta Analysis ◽

Adverse Outcomes ◽

Acid Suppression ◽

Gastric Acid Suppression

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PROGNOSTIC VALUE OF SERUM URIC ACID IN PATIENTS WITH ACUTE HEART FAILURE:A META-ANALYSIS

10.36106/gjra/0601830 ◽

2021 ◽

pp. 44-45

Author(s):

Mohit Desai ◽

Brajendra kumar

Keyword(s):

Uric Acid ◽

Observational Studies ◽

Prognostic Value ◽

Meta Analysis ◽

Prognostic Significance ◽

Adverse Outcomes ◽

Improve Risk Stratification ◽

Increased Risk ◽

All Cause Mortality ◽

Comprehensive Search

Our meta-analysis aimed to determine the prognostic significance of SUA level in patients with AHF.We made a comprehensive search in databases from inception to April 6, 2018. All available observational studies that evaluated the prognostic value of SUA level in patients with AHF were eligible. Outcome of interests were all-cause mortality and the combined endpoint of death or readmission. Prognostic values of SUA level were summarized as higher vs lower SUA category or per 1 mg/ml SUA rise.Eleven studies involving 12,854 AHF patients were identified and analyzed. AHF patients with the highest SUA level had an increased risk of all-cause mortality (risk ratio [RR] 1.43; 95% confidence intervals [CI] 1.31–1.56) and combined endpoint of death or readmission (RR 1.68; 95% CI 1.33–2.13) after adjusting potential variables. In addition, per 1 mg/ml SUA rise significantly increased by 11% and 12% higher risk all-cause mortality and combined endpoint of death or readmission, respectively..This meta-analysis indicates that elevated SUA level independently predicts all-cause mortality and the combined endpoint of death or readmission in AHF patients. Measurement of SUA level may improve risk stratification of adverse outcomes in these patients

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Adverse outcomes in older adults attending emergency departments: a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool

Age and Ageing ◽

10.1093/ageing/afw233 ◽

2016 ◽

Cited By ~ 6

Author(s):

Rose Galvin ◽

Yannick Gilleit ◽

Emma Wallace ◽

Gráinne Cousins ◽

Manon Bolmer ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

At Risk ◽

Emergency Departments ◽

Screening Tool ◽

Meta Analysis ◽

Adverse Outcomes

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Hepatitis C Virus Infection Increases the Risk of Adverse Outcomes Following Joint Arthroplasty: A Meta-analysis of Observational Studies

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2021.102947 ◽

2021 ◽

pp. 102947

Author(s):

Tao Cheng ◽

Chao Yang ◽

Liang Hao ◽

Xigao Cheng ◽

Jianjun Hu ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Observational Studies ◽

Meta Analysis ◽

Joint Arthroplasty ◽

Adverse Outcomes ◽

Hepatitis C Virus Infection

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The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies

Vaccines ◽

10.3390/vaccines9050529 ◽

2021 ◽

Vol 9 (5) ◽

pp. 529

Author(s):

Ruitong Wang ◽

Min Liu ◽

Jue Liu

Keyword(s):

Influenza Vaccination ◽

Clinical Outcomes ◽

Lower Risk ◽

Observational Studies ◽

Fixed Effects ◽

Meta Analysis ◽

Adverse Outcomes ◽

Policy Makers ◽

Subgroup Analyses ◽

Funnel Plots

Influenza could circulate in parallel with COVID-19. In the context of COVID-19, some studies observed inverse associations between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, while others did not. We conducted a meta-analysis to assess the association between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, aiming to provide evidence for COVID-19 prevention and vaccination promotion. We searched four databases from inception to 10 March, 2021. Random effects and fixed effects models were used to pool odds ratios (ORs) and adjusted estimates with 95% confidence intervals (CIs). We used funnel plots to evaluate the publication bias, I2 statistics to evaluate the heterogeneity, and conducted subgroup analyses. Sixteen observational studies involving 290,327 participants were included. Influenza vaccination was associated with a lower risk of SARS-CoV-2 infection (pooled adjusted OR: 0.86, 95%CI: 0.81–0.91), while not significantly associated with adverse outcomes (intensive care: adjusted OR 0.63, 95%CI: 0.22–1.81; hospitalization: adjusted OR 0.74, 95%CI: 0.51–1.06; mortality: adjusted OR 0.89, 95%CI: 0.73–1.09). Our findings suggest that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection. It is crucial for policy makers to implement strategies on influenza vaccination, for it may also have benefits for COVID-19 prevention.

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Prevalence of the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in Patients With Brucellosis: A Meta-Analysis

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1070 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A525-A525

Author(s):

Mouhand F H Mohamed ◽

Mhd Baraa Habib ◽

Arwa Alsaud ◽

Ashraf O Ahmed

Keyword(s):

Antidiuretic Hormone ◽

Observational Studies ◽

Meta Analysis ◽

Middle Eastern ◽

Hormone Secretion ◽

Adverse Outcomes ◽

Inappropriate Antidiuretic Hormone Secretion ◽

Antidiuretic Hormone Secretion ◽

Quantitative Synthesis ◽

Chronic Fever

Abstract Background: Hyponatremia is prevalent amongst hospitalized patients and is associated with adverse outcomes. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. In our experience in a middle eastern country, we observed a relationship between brucellosis and SIADH associated hyponatremia. Nonetheless, there is limited literature describing this association. Thus, we aimed to systematically review the literature and pool the prevalence of SIADH in patients with brucellosis. Methods: We comprehensively searched PubMed, EMBASE, and Google scholar (first 100 hits) for observational studies ascertaining the prevalence of SIADH in brucellosis patients. We had no age, language, or date limitations. We used a proportion meta-analysis utilizing the random-effects model with double arcsine transformation. I2 was used to ascertain heterogeneity. We used MetaXl software for statistical analysis. The protocol was preregistered at PROSPERO. Results: Our search in PubMed and EMBASE retrieved 107 articles, of which only four observational studies were relevant. Aysha et al. conducted the first analysis of 58 brucellosis patients in which 24% had sodium levels of less than 130 mmol/L. We excluded this study from our quantitative synthesis as the SIADH prevalence could not be accurately ascertained. Finally, the quantitative synthesis comprised three studies encompassing 306 patients and revealed a pooled SIADH prevalence of 20% (95% CI 0-52%, I2 96%). The quality assessment revealed low to moderate quality of included studies. Conclusion: The reported prevalence of SIADH in individual studies included in our analysis ranged from 3-56%. The results were heterogeneous, as depicted by a high I2. This varying prevalence is perhaps due to the varying age of included participants, definitions used by the primary studies, and the included data’s observational nature. Nonetheless, our meta-analysis revealed a relatively high prevalence of SIADH of 20% in patients with brucellosis. Hence, hyponatremia in patients with chronic fever should prompt a workup for SIADH and brucellosis, especially in endemic areas for brucellosis. Larger prospective studies are needed to ascertain the exact prevalence of SIADH in this patient cohort and its impact on the overall prognosis.

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