scholarly journals Activation of the innate immune response and organ injury after cardiac surgery: a systematic review and meta-analysis of randomised trials and analysis of individual patient data from randomised and non-randomised studies

2021 ◽  
Author(s):  
Riccardo G. Abbasciano ◽  
Florence Y. Lai ◽  
Marius A. Roman ◽  
Angelica Rizzello ◽  
Suraj Pathak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Immune Response ◽  
Cardiac Surgery ◽  
Innate Immune Response ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Innate Immune ◽  
Organ Injury ◽  
Randomised Trials

scholarly journals Long Term Surgical Outcomes For Infective Endocarditis In People Who Inject Drugs: A Systematic Review And Meta-Analysis

2019 ◽  
Author(s):  
David Goodman-Meza ◽  
Robert E Weiss ◽  
Sebastian Gamboa ◽  
Abel Gallegos ◽  
Alex AT Bui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
People Who Inject Drugs ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
The United States ◽  
Patient Data ◽  
Long Term Outcomes

Abstract Background: In the United States, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID. Methods: We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID . Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival. Results: We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3%, 81.0%, 62.1%, and 56.6% in PWID, respectively; and 96.4%, 85.0%, 70.3%, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05-2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25-4.50) than non-PWID. Conclusion: PWID were younger and had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.

scholarly journals Long Term Surgical Outcomes For Infective Endocarditis In People Who Inject Drugs: A Systematic Review And Meta-Analysis

2019 ◽  
Author(s):  
David Goodman-Meza ◽  
Robert E Weiss ◽  
Sebastian Gamboa ◽  
Abel Gallegos ◽  
Alex AT Bui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
People Who Inject Drugs ◽  
Cox Regression ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Long Term Outcomes

Abstract Background: In recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID. Methods: We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID . Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival. Results: We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3%, 81.0%, 62.1%, and 56.6% in PWID, respectively; and 96.4%, 85.0%, 70.3%, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05-2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25-4.50) than non-PWID. Conclusion: PWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.

scholarly journals Long term surgical outcomes for infective endocarditis in people who inject drugs: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
David Goodman-Meza ◽  
Robert E. Weiss ◽  
Sebastián Gamboa ◽  
Abel Gallegos ◽  
Alex A. T. Bui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
People Who Inject Drugs ◽  
Cox Regression ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Long Term Outcomes

Abstract Background In recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID. Methods We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID. Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival. Results We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3, 81.0, 62.1, and 56.6% in PWID, respectively; and 96.4, 85.0, 70.3, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05–2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25–4.50) than non-PWID. Conclusion PWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.

scholarly journals Long Term Surgical Outcomes for Infective Endocarditis in People Who Inject Drugs: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
David Goodman-Meza ◽  
Robert E Weiss ◽  
Sebastian Gamboa ◽  
Abel Gallegos ◽  
Alex AT Bui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
People Who Inject Drugs ◽  
Cox Regression ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Long Term Outcomes

Abstract Background: In recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID. Methods: We systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID . Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival. Results: We included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3%, 81.0%, 62.1%, and 56.6% in PWID, respectively; and 96.4%, 85.0%, 70.3%, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05-2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25-4.50) than non-PWID. Conclusion: PWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.

Sentinel Lymph Node Procedure in Colon Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data

2020 ◽  
Author(s):  
Marjolein Ankersmit ◽  
Martijn W. Heymans ◽  
Otto Hoekstra ◽  
Stijn L. Vlek ◽  
Linda J. Schoonmade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Sentinel Lymph Node Procedure

scholarly journals Genome-wide copy number variations as molecular diagnostic tool for cutaneous intermediate melanocytic lesions: a systematic review and individual patient data meta-analysis

2021 ◽  
Author(s):  
Chiel F. Ebbelaar ◽  
Anne M. L. Jansen ◽  
Lourens T. Bloem ◽  
Willeke A. M. Blokx
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Copy Number ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Copy Number Variations ◽  
Patient Data ◽  
Melanocytic Lesions ◽  
Genome Wide ◽  
Malignant Lesions

AbstractCutaneous intermediate melanocytic neoplasms with ambiguous histopathological features are diagnostically challenging. Ancillary cytogenetic techniques to detect genome-wide copy number variations (CNVs) might provide a valuable tool to allow accurate classification as benign (nevus) or malignant (melanoma). However, the CNV cut-off value to distinguish intermediate lesions from melanoma is not well defined. We performed a systematic review and individual patient data meta-analysis to evaluate the use of CNVs to classify intermediate melanocytic lesions. A total of 31 studies and 431 individual lesions were included. The CNV number in intermediate lesions (median 1, interquartile range [IQR] 0–2) was significantly higher (p<0.001) compared to that in benign lesions (median 0, IQR 0–1) and lower (p<0.001) compared to that in malignant lesions (median 6, IQR 4–11). The CNV number displayed excellent ability to differentiate between intermediate and malignant lesions (0.90, 95% CI 0.86–0.94, p<0.001). Two CNV cut-off points demonstrated a sensitivity and specificity higher than 80%. A cut-off of ≥3 CNVs corresponded to 85% sensitivity and 84% specificity, and a cut-off of ≥4 CNVs corresponded to 81% sensitivity and 91% specificity, respectively. This individual patient data meta-analysis provides a comprehensive overview of CNVs in cutaneous intermediate melanocytic lesions, based on the largest pooled cohort of ambiguous melanocytic neoplasms to date. Our meta-analysis suggests that a cut-off of ≥3 CNVs might represent the optimal trade-off between sensitivity and specificity in clinical practice to differentiate intermediate lesions from melanoma.

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