Clinical and social factors associated with increased risk for involuntary psychiatric hospitalisation: a systematic review, meta-analysis, and narrative synthesis

The incidence of respiratory disease is increasing. In relation to this, in addition to infection, factors associated with working with chemical insecticides are a cause for concern. Some of the chemicals involved have been shown to affect the respiratory system, and consequentially workers are at increased risk of conditions such as asthma. However, medical opinion around this area is still controversial; therefore, the objective of this study is to investigate the association between exposure to insecticides and asthma by means of a systematic review of the relevant literature. Relevant literature was identified, and a systematic review was conducted to investigate the association between exposure to insecticides and asthma. A total of five studies (three cross sectional and two cohort) including 45,435 subjects were identified as relevant. The summary odds ratios related to the impact of exposure to specific insecticides on asthma were organophosphates 1.31 (95%CI = 1.17–1.48, I2 = 27%, p = 0.172), carbamates 1.44 (95%CI 1.08–1.92, I2 = 56.7%, p = 0.031) and organochlorines 1.31 (95%CI 1.19–1.64, I2 = 37.3%, p = 0.131). Farmers exposed to certain insecticides may have an increased risk of asthma and asthmatic symptoms, but further research on that issue is urgently needed.

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Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses

BMJ Open ◽

10.1136/bmjopen-2018-024086 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024086 ◽

Cited By ~ 22

Author(s):

Kapil Gupta ◽

Mahesh Nagappa ◽

Arun Prasad ◽

Lusine Abrahamyan ◽

Jean Wong ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Respiratory Depression ◽

Meta Analysis ◽

Sleep Apnoea ◽

Factors Associated ◽

Obstructive Sleep ◽

Increased Risk ◽

Daily Dose ◽

Morphine Equivalent

ObjectiveThis systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).DesignSystematic review and meta-analysis.Data sourcesPubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials.gov (January 1946 to November 2017).Eligibility criteriaThe inclusion criteria were: (1) adult patients 18 years or older who were administered opioids after surgery and developed postoperative OIRD (OIRD group); (2) all studies which reported both OIRD events and associated risk factors; (3) all studies with reported data for each risk factor on patients with no OIRD (control group) and (4) published articles in English language.Data analysisWe used a random effects inverse variance analysis to evaluate the existing evidence of risk factors associated with OIRD. Newcastle-Ottawa scale scoring system was used to assess quality of study.ResultsTwelve observational studies were included from 8690 citations. The incidence of postoperative OIRD was 5.0 cases per 1000 anaesthetics administered (95% CI: 4.8 to 5.1; total patients: 841 424; OIRD: 4194). Eighty-five per cent of OIRD occurred within the first 24 hours postoperatively. Increased risk for OIRD was associated with pre-existing cardiac disease (OIRD vs control: 42.8% vs 29.6%; OR: 1.7; 95% CI: 1.2 to 2.5; I2: 0%; p<0.002), pulmonary disease (OIRD vs control: 17.8% vs 10.3%; OR: 2.2; 95% CI: 1.3 to 3.6; I2: 0%; p<0.001) and obstructive sleep apnoea (OIRD vs control: 17.9% vs 16.5%; OR: 1.4; 95% CI: 1.2 to 1.7; I2: 31%; p=0.0003). The morphine equivalent daily dose of the postoperative opioids was higher in the OIRD group than in the control; (24.7±14 mg vs 18.9±13.0 mg; mean difference: 2.8; 95% CI: 0.4 to 5.3; I2: 98%; p=0.02). There was no significant association between OIRD and age, gender, body mass index or American Society of Anesthesiologists physical status.ConclusionPatients with cardiac, respiratory disease and/or obstructive sleep apnoea were at increased risk for OIRD. Patients with postoperative OIRD received higher doses of morphine equivalent daily dose.

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Childhood trauma and cognitive biases associated with psychosis: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0246948 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246948

Author(s):

Jazz Croft ◽

David Martin ◽

Paul Madley-Dowd ◽

Daniela Strelchuk ◽

Jonathan Davies ◽

...

Keyword(s):

Systematic Review ◽

Childhood Trauma ◽

Probabilistic Reasoning ◽

Cognitive Biases ◽

Source Monitoring ◽

Meta Analysis ◽

Psychotic Symptoms ◽

Narrative Synthesis ◽

Increased Risk ◽

Study Characteristics

Childhood trauma is associated with an increased risk of psychosis, but the mechanisms that mediate this relationship are unknown. Exposure to trauma has been hypothesised to lead to cognitive biases that might have causal effects on psychotic symptoms. The literature on whether childhood trauma is associated with psychosis-related cognitive biases has not been comprehensively reviewed. A systematic review and meta-analysis or narrative synthesis of studies examining the association between childhood trauma and the following biases: external locus of control (LOC), external attribution, probabilistic reasoning, source monitoring, top-down processing, and bias against disconfirmatory evidence. Studies were assessed for quality, and sources of heterogeneity were explored. We included 25 studies from 3,465 studies identified. Individuals exposed to childhood trauma reported a more external LOC (14 studies: SMD Median = 0.40, Interquartile range 0.07 to 0.52), consistent with a narrative synthesis of 11 other studies of LOC. There was substantial heterogeneity in the meta-analysis (I2 = 93%) not explained by study characteristics examined. Narrative syntheses for other biases showed weaker, or no evidence of association with trauma. The quality of included studies was generally low. Our review provides some evidence of an association between childhood trauma and a more external LOC, but not with the other biases examined. The low quality and paucity of studies for most of the cognitive biases examined highlights the need for more rigorous studies to determine which biases occur after trauma, and whether they mediate an effect of childhood trauma on psychosis.

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Long-term sequelae of Pneumococcal Sepsis in children: a systematic review

10.1101/2021.03.15.21253639 ◽

2021 ◽

Author(s):

Adeteju A Ogunbameru ◽

Rafael N Miranda ◽

Joanna Bielecki ◽

Beate Sander

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Pediatric Patients ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Factors Associated ◽

Pneumococcal Sepsis ◽

Increased Risk ◽

Meta Analyses

Background: Long-term sequelae associated with pneumococcal sepsis (PS) in pediatric patients in existing literature is currently unclear. Aim: To review the evidence on sequelae and prognostic factors associated with PS among pediatric patients. Method: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. We screened six databases from their inception to January 15, 2021. Study population were neonates, infants, children and adolescents less than 18 years old with suspected or confirmed PS disease. Outcomes included sequelae types, prognostic factors, pooled death estimate and length of hospital stay (LOS) for survivors and deceased patients. Quality of studies was assessed using Joanna Briggs Institute appraisal checklists. Results: We screened 981 abstracts, and 24 full-text articles for final review. Septic shock was the most prevalent physical sequelae reported (13%, n=1492 patients). No functional, cognitive or neurological sequelae were reported in included studies. Meta-analysis of pooled mortality estimate was 14.6% (95%CI: 9.9 -19.4%). Prognostic factors associated with increased risk of PS sequelae and death included pediatric risk of mortality score ≥ 10 and co-infection with meningitis. LOS for survivors and non-survivors ranged between 5-30 days and 1-30 days. Nine included studies met at least 50% of the quality assessment criteria. Conclusion: Physical sequelae and death are the PS sequelae types currently identified in existing literature. Lack of information about other possible sequelae types suggests the long-term consequences of PS disease maybe underreported, especially in resource-limited settings. Future studies should consider exploring reasons for the existing of this knowledge gap.

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Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

10.21203/rs.3.rs-41459/v1 ◽

2020 ◽

Author(s):

Tayler A Buchan ◽

Behnam Sadeghirad ◽

Nayeli Schmutz ◽

Nicolai Goettel ◽

Farid Foroutan ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Elderly Patients ◽

Postoperative Delirium ◽

Individual Patient Data ◽

Elective Surgery ◽

Meta Analysis ◽

Patient Data ◽

Factors Associated ◽

Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients.

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Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

10.21203/rs.3.rs-41459/v2 ◽

2020 ◽

Author(s):

Tayler A Buchan ◽

Behnam Sadeghirad ◽

Nayeli Schmutz ◽

Nicolai Goettel ◽

Farid Foroutan ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Elderly Patients ◽

Postoperative Delirium ◽

Individual Patient Data ◽

Elective Surgery ◽

Meta Analysis ◽

Patient Data ◽

Factors Associated ◽

Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (³ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration: CRD42020171366

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Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

Systematic Reviews ◽

10.1186/s13643-020-01518-z ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Tayler A. Buchan ◽

Behnam Sadeghirad ◽

Nayeli Schmutz ◽

Nicolai Goettel ◽

Farid Foroutan ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Elderly Patients ◽

Postoperative Delirium ◽

Individual Patient Data ◽

Elective Surgery ◽

Meta Analysis ◽

Patient Data ◽

Factors Associated ◽

Increased Risk

Abstract Background Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes. Methods We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach. Discussion Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration CRD42020171366.

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