Surge Capacity of Hospitals in Emergencies and Disasters With a Preparedness Approach: A Systematic Review

2017 ◽  
Vol 11 (5) ◽  
pp. 612-620 ◽  
Author(s):  
Hojjat Sheikhbardsiri ◽  
Ahmad Reza Raeisi ◽  
Mahmood Nekoei-moghadam ◽  
Fatemeh Rezaei
Keyword(s):  
Systematic Review ◽  
Disaster Preparedness ◽  
Controlled Trial ◽  
Basic Element ◽  
Main Concern ◽  
Sudden Increase ◽  
Cross Sectional ◽  
Surge Capacity ◽  
Number Of Patients ◽  
Hospital Preparedness

AbstractObjectiveSurge capacity is one of the most important components of hospital preparedness for responding to emergencies and disasters. The ability to provide health and medical care during a sudden increase in the number of patients or victims of disasters is a main concern of hospitals. We aimed to perform a systematic review of hospital surge capacity in emergencies and disasters with a preparedness approach.MethodsA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words “surge,” “surge capacity,” “preparedness,” “hospital emergency department,” “hospital,” “surge capability,” “emergency,” “hazard,” “disaster,” “catastrophe,” “crisis,” and “tragedy” were used in combination with the Boolean operators OR and AND. The Google Scholar, ISI Web of Science, Science Direct, PubMed, Scopus, Ovid, Pro Quest, and Wiley databases were searched.ResultsA total of 1008 articles were extracted and 17 articles were selected for final review of surge capacity based on the objective of the study. Seventeen studies (1 randomized controlled trial, 2 qualitative studies, and 14 cross-sectional studies) investigated the surge capacity of hospitals in emergencies and disasters to evaluate the best evidence to date. The results of selected articles indicated that there are various ways to increase the capacity of hospitals in 4 domains: staff, stuff, structure, and system.ConclusionSurge capacity is a basic element of disaster preparedness programs. Results of the current study could help health field managers in hospitals to prepare for capacity-building based on surge capacity components to improve and promote hospital preparedness programs. (Disaster Med Public Health Preparedness. 2017;11:612–620)

Additional appointments and discomfort associated with compliance-free fixed Class II corrector treatment: a systematic review

2018 ◽  
Vol 41 (4) ◽  
pp. 404-414 ◽  
Author(s):  
Ashley Phuong ◽  
Nathalia Carolina Fernandes Fagundes ◽  
Sahar Abtahi ◽  
Mary Roduta Roberts ◽  
Paul W Major ◽  
...  
Keyword(s):  
Systematic Review ◽  
Selection Process ◽  
Grey Literature ◽  
Class Ii ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Low Level ◽  
Weak Recommendation ◽  
Number Of Patients ◽  
Cross Sectional Studies

Summary Objective A critical analysis of the literature to determine the prevalence and type of emergency/additional appointments, and discomfort levels associated with fixed Class II correctors. Methods Studies examining patient’s sources of discomfort or emergency appointments associated with compliance-free Class II correctors were included. Comprehensive searches up to July 2018 were conducted using the following databases: MEDLINE (OvidSP), PubMed, Web of Science, and Embase. A partial grey literature search was taken using Google Scholar and OpenGrey. Two reviewers independently performed the selection process and risk of bias assessment. The Newcastle-Ottawa Scale for cross-sectional studies were used. A summary of the overall strength of evidence was presented using ‘Grading of Recommendations, Assessment, Development and Evaluation’ (GRADE) tool. Included studies were evaluated according to their design, study quality, consistency, and directness. Results The selected studies were published between 2001 and 2018, and the number of patients per studied group ranged from 8 to 182. One thousand five hundred forty-two patients were evaluated in total. The patients’ mean age at start of treatment ranged from 10 to 16.9 years and the fixed Class II corrector treatment duration ranged from 4 to 12 months. The included studies in this systematic review were too clinically heterogeneous (different appliances, different data recollection processes) to justify a meta-analysis. Limitations This review was not previously registered. A low level of evidence was observed among the two randomized trials, the 10 cohorts and three cross-sectional studies identified. Conclusions The main source of discomfort from Forsus-type appliances appears to be soreness in the cheeks (low level of evidence with a weak recommendation strength). Most evaluated patients treated with a Herbst appliance, regardless of design, will experience complications (fractures and/or dislodging) requiring emergency appointments (low level of evidence with a weak recommendation strength). Registration The review protocol was not registered.

scholarly journals A systematic review of the effects of nicotine replacement therapy on agitation among nicotine-dependent psychiatric inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S296-S296
Author(s):  
Joseph Toms ◽  
Jacob King
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Controlled Trial ◽  
Psychiatric Inpatients ◽  
Cochrane Collaboration ◽  
Search Strategies ◽  
Primary Data ◽  
Psychiatric Admission ◽  
Cross Sectional ◽  
Nicotine Replacement

AimsThis systematic review aims to evaluate the effect of nicotine replacement therapies (NRTs) on measures of agitation amongst nicotine-dependent adult psychiatric inpatients.BackgroundSince the introduction of the smoke-free policy for all psychiatric facilities, a psychiatric admission is likely to upset a nicotine-dependent individual's normal routine of nicotine consumption. In addition to the physiological effects of nicotine withdrawal (NW), the interpersonal dynamic which nurse-led guardianship of nicotine products constructs presents stressors to the nicotine dependent patient.Several systematic reviews evaluating changes in objective measures of agitation amongst smoking patients in medical critical care units have found varied results, with some demonstrating worsening agitation with NRT use. We therefore believe that there is sufficient equipoise in the use of NRT to prompt a review of studies amongst psychiatric inpatients.MethodThis review identified English language studies through developed search strategies in PubMed/MEDLINE, EMBASE, PyschINFO, PSYCHLit, Cochrane databases, and Google scholar. The bibliographies of notable papers were explored. Hand searches of five major psychiatric journals were conducted. Peer reviewed studies of any study design were included if they reported primary data of adult psychiatric inpatients. Studies were extracted from 1990 – present, this was felt appropriate as nicotine replacement patches became available in 1992.Search strategies were informed by MeSH search terms and included multiple conceptions of “agitation”, including variations on; agitation, irritability, and arousal to capture the concept from broad academic constructions. The quality of studies was assessed with the Newcastle-Ottawa and Cochrane Collaboration tools.This review follows PRISMA guidelines, and an application for PROSPERO registration has been submitted pending acceptance.ResultTwo studies were identified which matched inclusion criteria. A double-blinded randomised placebo-controlled trial of 40 nicotine-dependent inpatients from Allen et al. reported a significant 23% reduction in Agitated Behaviour Scores at 24 hours following NRT administration on admission compared to their matched placebo controls. Yet a retrospective cross-sectional analysis from Okoli using scores for NW identified more severe withdrawal symptoms including “restlessness” and “anger/irritability” than nicotine-dependent patients not provided with NRT.ConclusionDespite considerable commentary within literature there is presently only one study providing moderate evidence of a positive benefit to measures of agitated behaviour from the use of NRT amongst nicotine-dependent psychiatric inpatients. There is currently very low evidence whether NRT improves or exacerbates the agitation associated with NW amongst nicotine-dependent psychiatric inpatients.

Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review

2018 ◽  
Vol 36 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Christopher Lemon ◽  
Michael De Ridder ◽  
Mohamed Khadra
Keyword(s):  
Systematic Review ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Planning Process ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Decision Aids ◽  
Automatic Identification ◽  
Cross Sectional ◽  
Identification Software

Background: Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. Objectives: To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. Design: Systematic review of articles in English, published from inception of databases to December 2017. Data Sources: PubMed, PsycINFO, EMBASE, and CINAHL. Methods/Measurements: Four databases were searched from inception to December 2017. Randomized and nonrandomized quantitative studies examining the effects of EMRs on creation, storage, or use of ADs were included. All featured an advance care planning process. Evidence was evaluated using the Cochrane Collaboration’s risk assessment tool. Results: Fifteen studies were included: 1 randomized controlled trial, 1 randomized pilot, 4 pre–post studies, 4 cross-sectional studies, 1 retrospective cohort study, 1 historical control study, 1 retrospective observational study, 1 retrospective review, and 1 evaluation of an EMR feature. Seven studies showed that EMR-based reminders, AD templates, and decision aids can improve AD documentation rates. Three demonstrated that EMR search functions, decision aids, and automatic identification software can help identify patients who have or need ADs according to certain criteria. Five showed EMRs can create documentation challenges, including locating ADs, and making some patients more likely than others to have an AD. Most studies had an unclear or high risk of bias. Conclusions: Limited evidence suggests EMRs could be used to help address AD documentation challenges but may also create additional problems. Stronger evidence is needed to more conclusively determine how EMR may assist in population approaches to improving AD documentation.

scholarly journals Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Saad Alhumaid ◽  
Abbas Al Mutair ◽  
Zainab Al Alawi ◽  
Ali A. Rabaan ◽  
Raghavendra Tirupathi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Case Series ◽  
Incidence Rates ◽  
Effect Sizes ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Pooled Prevalence ◽  
History Of

Abstract Background Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p =  < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p =  < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.

scholarly journals Sex Differences in Presentation of Stroke: A Systematic Review and Meta-Analysis

Stroke ◽  
2021 ◽  
Author(s):  
Mariam Ali ◽  
Hendrikus J.A. van Os ◽  
Nelleke van der Weerd ◽  
Jan W. Schoones ◽  
Martijn W. Heymans ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sex Differences ◽  
Acute Stroke ◽  
Transient Ischemic Attack ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Neurological Symptoms ◽  
Cross Sectional ◽  
Ischemic Attack ◽  
Meta Analyses

Background and Purpose: Women have worse outcomes than men after stroke. Differences in presentation may lead to misdiagnosis and, in part, explain these disparities. We investigated whether there are sex differences in clinical presentation of acute stroke or transient ischemic attack. Methods: We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Inclusion criteria were (1) cohort, cross-sectional, case-control, or randomized controlled trial design; (2) admission for (suspicion of) ischemic or hemorrhagic stroke or transient ischemic attack; and (3) comparisons possible between sexes in ≥1 nonfocal or focal acute stroke symptom(s). A random-effects model was used for our analyses. We performed sensitivity and subanalyses to help explain heterogeneity and used the Newcastle-Ottawa Scale to assess bias. Results: We included 60 studies (n=582 844; 50% women). In women, headache (pooled odds ratio [OR], 1.24 [95% CI, 1.11–1.39]; I 2 =75.2%; 30 studies) occurred more frequently than in men with any type of stroke, as well as changes in consciousness/mental status (OR, 1.38 [95% CI, 1.19–1.61]; I 2 =95.0%; 17 studies) and coma/stupor (OR, 1.39 [95% CI, 1.25–1.55]; I 2 =27.0%; 13 studies). Aspecific or other neurological symptoms (nonrotatory dizziness and non-neurological symptoms) occurred less frequently in women (OR, 0.96 [95% CI, 0.94–0.97]; I 2 =0.1%; 5 studies). Overall, the presence of focal symptoms was not associated with sex (pooled OR, 1.03) although dysarthria (OR, 1.14 [95% CI, 1.04–1.24]; I 2 =48.6%; 11 studies) and vertigo (OR, 1.23 [95% CI, 1.13–1.34]; I 2 =44.0%; 8 studies) occurred more frequently, whereas symptoms of paresis/hemiparesis (OR, 0.73 [95% CI, 0.54–0.97]; I 2 =72.6%; 7 studies) and focal visual disturbances (OR, 0.83 [95% CI, 0.70–0.99]; I 2 =62.8%; 16 studies) occurred less frequently in women compared with men with any type of stroke. Most studies contained possible sources of bias. Conclusions: There may be substantive differences in nonfocal and focal stroke symptoms between men and women presenting with acute stroke or transient ischemic attack, but sufficiently high-quality studies are lacking. More studies are needed to address this because sex differences in presentation may lead to misdiagnosis and undertreatment.

scholarly journals Food Insecurity and Cognitive Function in Middle to Older Adulthood: A Systematic Review

2019 ◽  
Vol 11 (3) ◽  
pp. 667-676 ◽  
Author(s):  
Muzi Na ◽  
Nan Dou ◽  
Naiwen Ji ◽  
Dixin Xie ◽  
Jie Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Food Insecurity ◽  
Cognitive Functions ◽  
Data Extraction ◽  
Controlled Trial ◽  
Later Life ◽  
Cross Sectional ◽  
Older Adulthood ◽  
Global Cognitive Function

ABSTRACT Food insecurity (FI) may limit cognitive functioning during aging. The goal of this systematic review was to summarize existing evidence linking FI and general or specific cognitive functions in middle and older adulthood. A systematic search of human studies published between 1 January 2000 and 30 April 2018 was conducted in PubMed, PsycINFO, and CAB Direct. Four independent reviewers assessed the eligibility of identified articles and conducted data extraction and data quality assessment. Ten studies were included in the review, including 1 cluster-randomized controlled trial, 2 longitudinal studies, and 7 cross-sectional studies. Three studies reported the association between early-life FI experience and a global cognitive function measure. Nine studies reported later-life FI experience in relation to global or specific cognitive functions. The results suggest an adverse association between FI experienced in early or later life and global cognitive function; and between later-life FI and executive function and memory. Findings from the review are preliminary because of sparse data, heterogeneity across study populations, exposure and outcome assessments, and potential risk of bias across studies. Future studies are recommended to better understand the role of FI in cognitive function, with the goal of identifying possible critical windows for correction of FI in vulnerable subpopulations to prevent neurocognitive deficit in adulthood.

Gaps in post-disaster community changes in “building back better” in Ayeyarwaddy, Myanmar

2020 ◽  
Vol 29 (4) ◽  
pp. 523-539
Author(s):  
Yunjeong Yang
Keyword(s):  
Disaster Preparedness ◽  
Controlled Trial ◽  
Household Survey ◽  
Analytical Framework ◽  
Design Stage ◽  
Self Assessment ◽  
Cross Sectional ◽  
Content Type ◽  
Evaluation Strategies ◽  
Post Hoc

Purpose The purpose of this paper is to assess the effectiveness of disaster risk reduction (DRR) projects carried out by a Korean NGO in Ayeyarwaddy, Myanmar. The paper discusses project effectiveness, community participation and sustainability in disaster preparedness as well as the “build back better” concept. Design/methodology/approach The findings are drawn from a mixed methods approach consisting of focus groups, interviews of key stakeholders and a cross-sectional community household survey comparing project and neighbouring villages. Findings Project villages were better prepared in terms of increased awareness and participation in DRR activities. However, the qualitative data showed a low level of participation, facilitating limited changes and leaving the element of sustainability in question. Most activities were responsive rather than preventive. Research limitations/implications The study faced unavoidable constraints. The author was invited to assess the project only after implementation, precluding a controlled trial. With time at the site limited, an alternative systematic post hoc evaluation strategies were not feasible. The triangulation of data manages these methodological challenges to the extent possible. Still, that the positive findings on preparedness and capacity changes derive from self-assessment should be kept in mind. Practical implications Where appropriate, DRR projects should include measurable evaluation tools from the project design stage. DRR as a goal in of itself is not adequate to transform the region. Instead, DRR projects should consider “development-centred disaster resilience” as the ultimate goal to aim toward. Originality/value There have been virtually no assessments of regional DRR project effectiveness in Myanmar. The study applies the Sendai Framework as an analytical framework to assess community-based DRR, which could also be applied to other contexts.

Tools and Checklists Used for the Evaluation of Hospital Disaster Preparedness: A Systematic Review

2016 ◽  
Vol 10 (5) ◽  
pp. 781-788 ◽  
Author(s):  
Mahmood Nekoie-Moghadam ◽  
Lisa Kurland ◽  
Mahmood Moosazadeh ◽  
Pier Luigi Ingrassia ◽  
Francesco Della Corte ◽  
...  
Keyword(s):  
Systematic Review ◽  
New York ◽  
Disaster Preparedness ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Evaluation Tool ◽  
Thomson Reuters ◽  
Hospital Preparedness ◽  
Meta Analyses ◽  
Hospital Disaster Preparedness

AbstractHospitals need to be fully operative during disasters. It is therefore essential to be able to evaluate hospital preparedness. However, there is no consensus of a standardized, comprehensive and reliable tool with which to measure hospital preparedness. The aim of the current study was to perform a systematic review of evaluation tools for hospital disaster preparedness. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words “crisis,” “disaster,” “disaster medicine,” “emergency,” “mass casualty,” “hospital preparedness,” “hospital readiness,” “hospital assessment,” “hospital evaluation,” “hospital appraisal,” “planning,” “checklist,” and “medical facility” were used in combination with the Boolean operators “OR” and “AND.” PubMed (National Library of Medicine, Bethesda, MD), ISI Web of Science (Thomson Reuters, New York, NY), and Scopus (Elsevier, New York, NY) were searched. A total of 51,809 publications were screened. The following themes were required for relevance: logistics, planning, human resources, triage, communication, command and control, structural and nonstructural preparedness, training, evacuation, recovery after disaster, coordination, transportation, surge capacity, and safety. The results from 15 publications are presented. Fifteen articles fulfilled the criteria of relevance and considered at least 1 of the 14 predetermined themes. None of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation. The results of the current systematic review could be used as a basis for designing an evaluation tool for hospital disaster preparedness. (Disaster Med Public Health Preparedness. 2016;page 1 of 8)

scholarly journals The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis

2017 ◽  
Vol 17 (1) ◽  
pp. 6-22 ◽  
Author(s):  
Andrea Driscoll ◽  
Maria J Grant ◽  
Diane Carroll ◽  
Sally Dalton ◽  
Christi Deaton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Nurse Staffing ◽  
Administrative Databases ◽  
Inhospital Mortality ◽  
Staffing Level ◽  
Cross Sectional ◽  
Staffing Levels ◽  
Number Of Patients

Background: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. Aim: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units. Methods: Nine electronic databases were searched for English articles published between 2006 and 2017. The primary outcomes were nurse-sensitive patient outcomes. Results: Of 3429 unique articles identified, 35 met the inclusion criteria. All were cross-sectional and the majority utilised large administrative databases. Higher staffing levels were associated with reduced mortality, medication errors, ulcers, restraint use, infections, pneumonia, higher aspirin use and a greater number of patients receiving percutaneous coronary intervention within 90 minutes. A meta-analysis involving 175,755 patients, from six studies, admitted to the intensive care unit and/or cardiac/cardiothoracic units showed that a higher nurse staffing level decreased the risk of inhospital mortality by 14% (0.86, 95% confidence interval 0.79–0.94). However, the meta-analysis also showed high heterogeneity (I2=86%). Conclusion: Nurse-to-patient ratios influence many patient outcomes, most markedly inhospital mortality. More studies need to be conducted on the association of nurse-to-patient ratios with nurse-sensitive patient outcomes to offset the paucity and weaknesses of research in this area. This would provide further evidence for recommendations of optimal nurse-to-patient ratios in acute specialist units.

scholarly journals Salivary Biomarkers for Diagnosis and Therapy Monitoring in Patients with Heart Failure. A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 824
Author(s):  
Aidonis Rammos ◽  
Aris Bechlioulis ◽  
Petros Kalogeras ◽  
Evanthia E. Tripoliti ◽  
Yorgos Goletsis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Therapy Monitoring ◽  
Relevant Literature ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Salivary Biomarkers ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Randomized Control

The aim of this study was to perform a systematic review on the potential value of saliva biomarkers in the diagnosis, management and prognosis of heart failure (HF). The correlation between saliva and plasma values of these biomarkers was also studied. PubMed was searched to collect relevant literature, i.e., case-control, cross-sectional studies that either compared the values of salivary biomarkers among healthy subjects and HF patients, or investigated their role in risk stratification and prognosis in HF patients. No randomized control trials were included. The search ended on 31st of December 2020. A total of 15 studies met the inclusion criteria. 18 salivary biomarkers were analyzed and the levels of all biomarkers studied were found to be higher in HF patients compared to controls, except for amylase, sodium, and chloride that had smaller saliva concentrations in HF patients. Natriuretic peptides are the most commonly used plasma biomarkers in the management of HF. Their saliva levels show promising results, although the correlation of saliva to plasma values is weakened in higher plasma values. In most of the publications, differences in biomarker levels between HF patients and controls were found to be statistically significant. Due to the small number of patients included, larger studies need to be conducted in order to facilitate the use of saliva biomarkers in clinical practice.

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