Risk Factors for Cement Leakage After Vertebroplasty or Kyphoplasty: A Meta-Analysis of Published Evidence

Study Design: Meta-analysis. Objectives: To provide up-to-date evidence-based outcomes for the incidence and risk factors of adjacent vertebral fracture (AVF) after the vertebral augmentation. Methods: The MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies assessing the risk factors of adjacent vertebral fracture after vertebral augmentation until June 2020. The AVF incidence and factors potentially affecting AVF were extracted and pooled. Results: A total of 16 studies, encompassing 2549 patients were included in the meta-analysis. The pooled incidence of AVF was 14% after vertebral augmentation. Female, lower T-score, thoracolumbar junction fracture, intravertebral cleft, more injected cement volume, intradiscal cement leakage significantly increased the risk of AVF. Age, body mass index, steroid medication, Cobb angle change, postoperative Cobb angle showed no significant association with AVF. Conclusions: Identifying the risk factors of AVF can facilitate prevention strategy to avoid the AVF. Female, T-score, thoracolumbar junction fracture, intravertebral cleft, more cement volume, and intradiscal cement leakage increased the risk of AVF.

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Risk factors of the Secondary Fractures for Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebroplasty

10.21203/rs.2.20610/v1 ◽

2020 ◽

Author(s):

Xiao-kui Kang ◽

Sheng-fu Guo ◽

Hui-xin Liu ◽

Li-li Huang ◽

Qun-long Jiang

Keyword(s):

Risk Factors ◽

Percutaneous Vertebroplasty ◽

Meta Analysis ◽

Thoracolumbar Spine ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Secondary Fracture ◽

Compression Fractures ◽

Secondary Fractures

Abstract Background Percutaneous vertebroplasty related postoperative secondary fractures risk factors were not consistent in patients with osteoporotic vertebral compression Fractures. The purpose was to identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty.Methods Potential academic articles were identified from Cochrane Library, Medline, PubMed, Embase, ScienceDirect and other databases. The time range we retrieved from was that from the inception of electronic databases to August 2019. Gray studies were identified from the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas, USA) was used to analyze the pooled data.Results Fourteen studies involving 1910 patients, 395 of whom had secondary fracture following the surgery were included in this meta-analysis. The results of meta-analysis showed the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty was related to bone mineral density [WMD= -0.518, 95%CI(-0.784,-0.252), P=0.000], cement leakage [RR=0.596, 95%CI (0.444,0.798), P=0.001] and kyphosis after primary operation [WMD=4.510, 95%CI (3.061,6.004),P=0.000], but not to gender, age, body mass index (BMI), cement volume, thoracolumbar spine, and cement injection approaches.Conclusions BMD, cement leakage and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after percutaneous vertebroplasty. There has not been enough evidence to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approach.

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Mortality risk factors of COVID-19 infection in kidney transplantation recipients: a systematic review and meta-analysis of cohorts and clinical registries

Scientific Reports ◽

10.1038/s41598-021-99713-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Suwasin Udomkarnjananun ◽

Stephen J. Kerr ◽

Natavudh Townamchai ◽

Paweena Susantitaphong ◽

Wasee Tulvatana ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Kidney Transplantation ◽

Mortality Risk ◽

Case Reports ◽

Meta Analysis ◽

Factors Associated ◽

Presenting Symptoms ◽

Risk Of Death ◽

Published Evidence

AbstractKidney transplantation recipients (KTR) with coronavirus disease 2019 (COVID-19) are at higher risk of death than general population. However, mortality risk factors in KTR are still not clearly identified. Our objective was to systematically analyze published evidence for risk factors associated with mortality in COVID-19 KTR. Electronic databases were searched for eligible studies on 1 August 2021. All prospective and retrospective studies of COVID-19 in KTR were considered eligible without language restriction. Since data in case reports and series could potentially be subsets of larger studies, only studies with ≥ 50 patients were included. Random-effects model meta-analysis was used to calculate weighted mean difference (WMD) and pooled odds ratio (OR) of factors associated with mortality. From a total 1,137 articles retrieved, 13 were included in the systematic review and meta-analysis comprising 4,440 KTR. Compared with survivors, non-survivors were significantly older (WMD 10.5 years, 95% CI 9.3–11.8). KTR of deceased donor were at higher risk of death (OR 1.73, 95% CI 1.10–2.74). Comorbidities including diabetes mellitus, cardiovascular disease, and active cancer significantly increased mortality risk. KTR with dyspnea (OR 5.68, 95% CI 2.11–15.33) and pneumonia (OR 10.64, 95% CI 3.37–33.55) at presentation were at higher mortality risk, while diarrhea decreased the risk (OR 0.61, 95% CI 0.47–0.78). Acute kidney injury was associated with mortality (OR 3.24, 95% CI 1.36–7.70). Inflammatory markers were significantly higher in the non-survivors, including C-reactive protein, procalcitonin, and interleukine-6. A number of COVID-19 mortality risk factors were identified from KTR patient characteristics, presenting symptoms, and laboratory investigations. KTR with these risk factors should receive more intensive monitoring and early therapeutic interventions to optimize health outcomes.

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