The Impact of Penicillin Resistance on Short-Term Mortality in Hospitalized Adults with Pneumococcal Pneumonia: A Systematic Review and Meta-Analysis

Objective The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis. Data Sources We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813). Study Selection Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use. Data Extraction Two authors extracted the patients’ characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality. Data Synthesis Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I2 = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I2 = 0%). Conclusion Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.

Download Full-text

The impact of right ventricular injury on the mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis

Critical Care ◽

10.1186/s13054-021-03591-9 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Ryota Sato ◽

Siddharth Dugar ◽

Wisit Cheungpasitporn ◽

Mary Schleicher ◽

Patrick Collier ◽

...

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Hospital Mortality ◽

Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Meta Analysis ◽

Icu Mortality ◽

Short Term ◽

Short Term Mortality ◽

The Impact

Abstract Background Previous studies have found various incidences of right ventricular (RV) injury and its association with clinical outcome in patients with acute respiratory distress syndrome (ARDS). In this systematic review and meta-analysis, we aimed to investigate the impact of the presence of RV injury on mortality in patients with ARDS. Method We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for studies investigating the association between RV injury and mortality. Two authors independently evaluated whether studies meet eligibility criteria and extracted the selected patients’ and studies’ characteristics and outcomes. RV injury was diagnosed by trans-thoracic echocardiogram (TTE), trans-esophageal echocardiogram (TEE) and PAC (pulmonary artery catheter) in the included studies. The primary outcome was the association between mortality and the presence of RV injury in patients with ARDS. The overall reported mortality was defined as either the intensive care unit (ICU) mortality, in-hospital mortality, or mortality within 90 days, and short-term mortality was defined as ICU-mortality, in-hospital mortality, or mortality within 30 days. Results We included 9 studies (N = 1861 patients) in this meta-analysis. RV injury that included RV dysfunction, RV dysfunction with hemodynamic compromise, RV failure, or acute cor-pulmonale was present in 21.0% (391/1,861). In the pooled meta-analysis, the presence of RV injury in patients with ARDS was associated with significantly higher overall mortality (OR 1.45, 95% CI 1.13–1.86, p-value = 0.003, I2 = 0%), as well as short-term mortality (OR 1.48, 95% CI 1.14–1.93, p-value = 0.003, I2 = 0%). Conclusion In this systematic review and meta-analysis including 1861 patients with ARDS, the presence of RV injury was significantly associated with increased overall and short-term mortality. Trial registration: The protocol was registered at PROSPERO (CRD42020206521).

Download Full-text

The Impact of Right Ventricular Dysfunction on the Mortality in Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.

10.21203/rs.3.rs-291532/v1 ◽

2021 ◽

Author(s):

Ryota Sato ◽

Siddharth Dugar ◽

Wisit Cheungpasitporn ◽

Mary Schleicher ◽

Patrick Collier ◽

...

Keyword(s):

Systematic Review ◽

Right Ventricular ◽

Ventricular Dysfunction ◽

Meta Analysis ◽

Right Ventricular Dysfunction ◽

P Value ◽

Cochrane Central Register ◽

Short Term ◽

Short Term Mortality ◽

The Impact

Abstract Background: Previous studies have found various incidences of right ventricular dysfunction (RVD) and its association with clinical outcome. In this systematic review and meta-analysis, we aimed to investigate the impact of the presence of RVD on mortality in patients with ARDS.Method: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for studies investigating the association between RVD and mortality. Two authors independently evaluated whether studies meet eligibility criteria and extracted the selected patients’ and studies’ characteristics and outcomes. The primary outcome was the association between mortality and the presence of RVD in patients with ARDS. Results: We included 9 studies (N = 1,861 patients) in this meta-analysis. RVD was present in 21.0% (391/1,861). In the pooled meta-analysis, the presence of RVD in patients with ARDS was associated with significantly higher overall mortality (OR: 1.45, 95%CI: 1.13-1.86, p-value = 0.003, I2 = 0%), as well as short-term mortality (OR: 1.48, 95%CI: 1.14-1.93, p-value = 0.003, I2 = 0%).Conclusion: In this systematic review and meta-analysis including 1,861 patients with ARDS, the presence of RVD was significantly associated with increased overall and short-term mortality.Trial registration: The protocol was registered at PROSPERO (CRD42020206521).

Download Full-text

Endoscopic pituitary surgery: a systematic review and meta-analysis

Journal of Neurosurgery ◽

10.3171/2007.12.17635 ◽

2009 ◽

Vol 111 (3) ◽

pp. 545-554 ◽

Cited By ~ 189

Author(s):

Abtin Tabaee ◽

Vijay K. Anand ◽

Yolanda Barrón ◽

David H. Hiltzik ◽

Seth M. Brown ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Pituitary Surgery ◽

Small Sample ◽

Csf Leak ◽

Tumor Control ◽

Published Data ◽

Complication Rates ◽

Short Term ◽

The Impact

Object Surgery on the pituitary gland is increasingly being performed through an endoscopic approach. However, there is little published data on its safety and relative advantages over traditional microscope-based approaches. Published reports are limited by small sample size and nonrandomized study design. A meta-analysis allows for a description of the impact of endoscopic surgery on short-term outcomes. Methods The authors performed retrospective review of data from their institution as well as a systematic review of the literature. The pooled data were analyzed for descriptive statistics on short-term outcomes. Results Nine studies (821 patients) met inclusion criteria. Overall, the pooled rate of gross tumor removal was 78% (95% CI 67–89%). Hormone resolution was achieved in 81% (95% CI 71–91%) of adrenocorticotropic hormone secreting tumors, 84% (95% CI 76–92%) of growth hormone secreting tumors, and 82% (95% CI 70–94%) of prolactin secreting tumors. The pooled complication rates were 2% (95% CI 0–4%) for CSF leak and 1% (95% CI 0–2%) for permanent diabetes insipidus. There were 2 deaths reported in the literature that were both related to vascular injury, giving an overall mortality rate of 0.24%. Conclusions The results of this meta-analysis support the safety and short-term efficacy of endoscopic pituitary surgery. Future studies with long-term follow-up are required to determine tumor control.

Download Full-text

Comparison of Prognostic Accuracy of the quick Sepsis-Related Organ Failure Assessment between Short- & Long-term Mortality in Patients Presenting Outside of The Intensive Care Unit - A Systematic Review & Meta-analysis

10.1101/296459 ◽

2018 ◽

Cited By ~ 1

Author(s):

TOH LEONG TAN ◽

Ying Jing Tang ◽

Ling Jing Ching ◽

Noraidatulakma Abdullah ◽

Hui-min Neoh

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Short Term ◽

Suspected Infection ◽

Failure Assessment ◽

Short Term Mortality ◽

Short And Long Term ◽

Qsofa Score ◽

Long Term Mortality

Objective: In year 2016, quick Sepsis-Related Organ Failure Assessment (qSOFA) was introduced as a better sepsis screening tool compared to systemic inflammatory response syndrome (SIRS). The purpose of this systematic review and meta-analysis is to evaluate the ability of the qSOFA in predicting short- and long-term mortality among patients outside the intensive care unit setting. Method: Studies reporting on the qSOFA and mortality from MEDLINE (published between 1946 and 15th December 2017) and SCOPUS (published before 15th December 2017). Hand-checking of the references of relevant articles was carried out. Studies were included if they involved inclusion of patients presenting to the ED; usage of Sepsis-3 definition with suspected infection; usage of qSOFA score for mortality prognostication; and written in English. Study details, patient demographics, qSOFA scores, short-term (<30 days) and long-term (≥30 days) mortality were extracted. Two reviewers conducted all reviews and data extraction independently. Results and Discussion: A total of 39 studies met the selection criteria for full text review and only 36 studies were inclided. Data on qSOFA scores and mortality rate were extracted from 36 studies from 15 countries. The pooled odds ratio was 5.5 and 4.7 for short-term and long-term mortality respectively. The overall pooled sensitivity and specificity for the qSOFA was 48% and 85% for short-term mortality and 32% and 92% for long-term mortality, respectively. Studies reporting on short-term mortality were heterogeneous (Tau=24%, I2=94%, P<0.001), while long-term mortality studies were homogenous (Tau=0%, I2<0.001, P=0.52). The factors contributing to heterogeneity may be wide age group, various clinical settings, variation in the timing of qSOFA scoring, and broad range of clinical diagnosis and criteria. There was no publication bias for short-term mortality analysis. Conclusion: qSOFA score showed a poor sensitivity but moderate specificity for both short and long-term mortality prediction in patients with suspected infection. qSOFA score may be a cost-effective tool for sepsis prognostication outside of the ICU setting.

Download Full-text

Abstract P411: Prevalence, Characteristics and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Stroke ◽

10.1161/str.52.suppl_1.p411 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Konark MALHOTRA ◽

Christina Zompola ◽

Aikaterini Theodorou ◽

Aristeidis Katsanos ◽

Ashkan Shoamanesh ◽

...

Keyword(s):

Systematic Review ◽

Intracerebral Hemorrhage ◽

Meta Analysis ◽

Amyloid Angiopathy ◽

Short Term ◽

Pooled Prevalence ◽

Subgroup Analyses ◽

Short Term Mortality ◽

Cerebral Amyloid ◽

Undetermined Etiology

Objective: We sought to determine the prevalence, radiological characteristics, and clinical outcomes of intracerebral hemorrhage (ICH) of undetermined etiology. Methods: Systematic review and meta-analysis of studies involving patients with spontaneous ICH was conducted to assess the prevalence and clinical-radiological characteristics of undetermined ICH. Additionally, we assessed the rates for ICH secondary to hypertensive arteriopathy (HTN-A) and cerebral amyloid angiopathy (CAA). Subgroup analyses were performed based on the use of a) etiology-oriented ICH classification, b) detailed neuroimaging, and c) Boston criteria among CAA-ICH. Results: 24 studies were included (n=15,828; mean age: 64.8 years, males: 60.8%). The pooled prevalence of HTN-A ICH, undetermined ICH and CAA-ICH were 50% (95%CI: 43-58%), 18% (95%CI: 13-23%), and 12% (95%CI: 7-17%; p<0.001 between subgroups). The volume of ICH was largest in CAA-ICH 24.7mL (95%CI: 19.7-29.8mL), followed by HTN-A ICH 16.2mL (95%CI: 10.9-21.5mL) and undetermined ICH 15.4mL (95%CI: 6.2-24.5mL). Among patients with undetermined ICH, the rates of short-term mortality and intraventricular hemorrhage were 33% (95%CI: 25-42%) and 38% (95%CI: 28-48%), respectively. Subgroup analysis demonstrated a higher rate of undetermined ICH among studies that did not use an etiology-oriented classification (22%; 95%CI: 15-29%). No difference was observed between studies based on the completion of detailed neuroimaging to assess the rates of undetermined ICH (p=0.62). Conclusions: The etiology of spontaneous ICH remains undetermined among one in five patients in studies using etiology-oriented classification and among one in four patients in studies that avoid using etiology-oriented classification. The short-term mortality in undetermined ICH is high despite the relatively small ICH volume. Our findings suggest the use of etiology-oriented classification to approach ICH patients (Figure).

Download Full-text