Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

AbstractObjective:To estimate the attributable mortality, length of stay (LOS), and healthcare cost of pediatric and neonatal healthcare-acquired bloodstream infections (HA-BSIs).Design:A systematic review and meta-analysis.Methods:A systematic search (January 2000–September 2018) was conducted in PubMed, Cochrane, and CINAHL databases. Reference lists of selected articles were screened to identify additional studies. Case–control or cohort studies were eligible for inclusion when full text was available in English and data for at least 1 of the following criteria were provided: attributable or excess LOS, healthcare cost, or mortality rate due to HA-BSI. Study quality was evaluated using the Critical Appraisal Skills Programme Tool (CASP). Study selection and quality assessment were conducted by 2 independent researchers, and a third researcher was consulted to resolve any disagreements. Fixed- or random-effect models, as appropriate, were used to synthesize data. Heterogeneity and publication bias were evaluated.Results:In total, 21 studies were included in the systematic review and 13 studies were included in the meta-analysis. Attributable mean LOS ranged between 4 and 27.8 days; healthcare cost ranged between $1,642.16 and $160,804 (2019 USD) per patient with HA-BSI; and mortality rate ranged between 1.43% and 24%. The pooled mean attributable hospital LOS was 16.91 days (95% confidence interval [CI], 13.70–20.11) and the pooled attributable mortality rate was 8% (95% CI, 6–9). A meta-analysis was not conducted for cost due to lack of eligible studies.Conclusions:Pediatric HA-BSIs have a significant impact on mortality, LOS, and healthcare cost, further highlighting the need for implementation of HA-BSI prevention strategies.

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Local or general anesthesia for TAVI surgery? An updated systematic review and meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehab724.1670 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

D R Cheng

Keyword(s):

Systematic Review ◽

Mortality Rate ◽

Length Of Stay ◽

Cohort Studies ◽

Meta Analysis ◽

Hospital Length ◽

Cardiovascular Drugs ◽

Hospital Length Of Stay ◽

Procedure Time ◽

Procedural Success

Abstract Background The choice of anesthesia for transcatheter aortic valve implantation (TAVI) is still under controversial. This systematic review and meta-analysis was performed to evaluate the safety of local anesthesia (LA) with or without conscious sedation (CS) and general anesthesia (GA) for the TAVI-procedure. Methods This meta-analysis is registered with PROSPERO (CRD42021221777). We searched OVID, PUBMED, EMBASE, Web of Science databases to collect all the related studies published from January 1, 2002 to December 31, 2020. The primary outcome measures were hospital length of stay, operation time, 30-day mortality, use of cardiovascular drugs, permanent pacemaker (PPM) implantation rate, stroke rate, the incidence of myocardial infarction (MI), incidence of acute kidney injury (AKI), major bleeding (MB) rate, rate of procedural success. Results A total of 33 studies (3 RCT studies, 23 retrospective cohort studies, 4 prospective cohort studies, 3 case-control studies) including 23244 patients were analyzed. There were no significant statistically differences between LA and GA with respect to PPM [OR=0.99, 95% CI (0.88, 1.11), P=0.88], shock [OR=0.91, 95% CI (0.69, 1.21), P=0.52], MI [OR=0.89, 95% CI (0.52, 1.53), P=0.68], AKI [OR=1.26, 95% CI (0.99, 1.62), P=0.06], rate of procedural success [OR=0.66, 95% CI (0.43, 1.03), P=0.06]. However, compared to GA, LA for TAVI was associated with a significantly shorter hospital length of stay [WMD=−2.45, 95% CI (−2.77, −2.13), P<0.ehab724.16701], a reduction in procedure time [WMD=−12.32, 95% CI (−13.78, −10.87), P<0.ehab724.16701], a reduction in using of cardiovascular drugs [OR=0.52, 95% CI (0.35, 0.78), P=0.002] and in MB [OR=0.59, 95% CI (0.46, 0.75), P<0.0001], reduced 30-day mortality rate [OR=1.19, 95% CI (1.00, 1.42), P=0.05]. Conclusion This Systematic review and meta-analysis showed that compared to GA, LA for TAVI can reduce hospital length of stay, procedure time, 30-day mortality rate, use of cardiovascular drugs, and MB rate, but no significant differences in PPM, shock, MI, AKI, and the rate of procedural success. FUNDunding Acknowledgement Type of funding sources: None.

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Prevalence of Capgras syndrome in Alzheimer’s patients: A systematic review and meta-analysis

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn13-040014 ◽

2019 ◽

Vol 13 (4) ◽

pp. 463-468

Author(s):

Gabriela Caparica Muniz Pereira ◽

Gustavo Carvalho de Oliveira

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Effect Model ◽

Study Selection ◽

Capgras Syndrome

ABSTRACT The association between Capgras syndrome and Alzheimer’s disease has been reported in several studies, but its prevalence varies considerably in the literature, making it difficult to measure and manage this condition. Objective: This study aims to estimate the prevalence of Capgras syndrome in patients with Alzheimer’s disease through a systematic review, and to review etiological and pathophysiological aspects related to the syndrome. Methods: A systematic review was conducted using the Medline, ISI, Cochrane, Scielo, Lilacs, and Embase databases. Two independent researchers carried out study selection, data extraction, and qualitative analysis by strictly following the same methodology. Disagreements were resolved by consensus. The meta-analysis was performed using the random effect model. Results: 40 studies were identified, 8 of which were included in the present review. Overall, a total of 1,977 patients with Alzheimer’s disease were analyzed, and the prevalence of Capgras syndrome in this group was 6% (CI: 95% I² 54% 4.0-8.0). Conclusion: The study found a significant prevalence of Capgras syndrome in patients with Alzheimer’s disease. These findings point to the need for more studies on the topic to improve the management of these patients.

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Estimated prevalence of dental fear in adults: a systematic review and meta-analysis

10.1101/2020.11.30.20241216 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ethieli R. Silveira ◽

Mariana G. Cademartori ◽

Helena S. Schuch ◽

Jason M. Armfield ◽

Flavio F. Demarco

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Population Based ◽

Dental Fear ◽

Study Selection ◽

Pooled Prevalence ◽

Subgroup Analyses ◽

Fear And Anxiety

ABSTRACTObjectivesTo systematically review the literature on the prevalence of dental fear in adults to estimate a worldwide pooled prevalence and to investigate factors related to the heterogeneity of estimates.MethodsInclusion criteria were population-based studies reporting the prevalence or data that allowed the calculation of prevalence of dental fear in adults and/or elders. Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library (BVS) and Web of Science) were searched. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed to investigate variability between studies.ResultsThe search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 13.8%, 11.2% and 2.6%, respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instrument used to measure dental fear also affected the prevalence of the outcome.ConclusionsDental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women.

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Mortality associated with Blastomyces dermatitidis infection: A systematic review of the literature and meta-analysis

Medical Mycology ◽

10.1093/mmy/myz048 ◽

2019 ◽

Vol 58 (1) ◽

pp. 1-10

Author(s):

Alex Carignan ◽

Mélina Denis ◽

Claire Nour Abou Chakra

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Series ◽

Case Fatality ◽

Attributable Mortality ◽

Blastomyces Dermatitidis ◽

Immunocompromised Patients

Abstract Published case fatality in blastomycosis patients ranges between 4% and 78%. This study aimed to assess mortality associated with blastomycosis and identify its associated risk factors. We conducted a systematic review of publications related to Blastomyces dermatitidis available in PubMed and Scopus databases. Studies that reported data on blastomycosis mortality and that were published from inception through February 2018 were assessed and included in the analysis. Using the R meta package, a random-effect model meta-analysis was used to calculate pooled and stratified estimates of case-fatality proportions and risk ratios. Of 1553 publications, we included 20 studies reporting on a total of 2820 cases of blastomycosis between 1970 and 2014 and three case series reports with 10, 21, and 36 patients. The mean or median ages ranged from 28 to 59 years. Mortality was defined as attributable mortality caused by blastomycosis in 13 studies. Among 14 studies with a standard error ≤0.05, the overall pooled mortality was 6.6% (95% confidence interval [CI], 4.9–8.2) with 57% heterogeneity. The mortality rate was 37% (95% CI, 23–51) in immunocompromised patients and 75% (95% CI, 53–96) in patients who developed an acute respiratory distress syndrome (ARDS) (n = 3 studies each). ARDS was the only identified risk factor in general patients (risk ratio = 10.2). The overall mortality was significantly higher in studies involving immunocompromised patients and ARDS patients. Our analysis showed considerable heterogeneity among studies. Inconsistent mortality definitions may have contributed to the observed heterogeneity. Further research is needed to assess potential risk factors for mortality.

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Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis

Human Reproduction Update ◽

10.1093/humupd/dmz011 ◽

2019 ◽

Vol 25 (4) ◽

pp. 439-451 ◽

Cited By ~ 34

Author(s):

Nathalie Sermondade ◽

Stéphanie Huberlant ◽

Vanessa Bourhis-Lefebvre ◽

Elisangela Arbo ◽

Vanessa Gallot ◽

...

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Body Mass ◽

Live Birth ◽

Meta Analysis ◽

Random Effect ◽

Reproductive Age ◽

Cochrane Library ◽

Study Selection ◽

Subgroup Analyses

Abstract BACKGROUND A worldwide increase in the prevalence of obesity has been observed in the past three decades, particularly in women of reproductive age. Female obesity has been clearly associated with impaired spontaneous fertility, as well as adverse pregnancy outcomes. Increasing evidence in the literature shows that obesity also contributes to adverse clinical outcomes following in vitro fertilization (IVF) procedures. However, the heterogeneity of the available studies in terms of populations, group definition and outcomes prevents drawing firm conclusions. A previous meta-analysis published in 2011 identified a marginal but significant negative effect of increased female body mass index (BMI) on IVF results, but numerous studies have been published since then, including large cohort studies from national registries, highlighting the need for an updated review and meta-analysis. OBJECTIVE AND RATIONALE Our systematic review and meta-analysis of the available literature aims to evaluate the association of female obesity with the probability of live birth following IVF. Subgroup analyses according to ovulatory status, oocyte origin, fresh or frozen-embryo transfer and cycle rank were performed. SEARCH METHODS A systematic review was performed using the following key words: (‘obesity’, ‘body mass index’, ‘live birth’, ‘IVF’, ‘ICSI’). Searches were conducted in MEDLINE, EMBASE, Cochrane Library, Eudract and clinicaltrial.gov from 01 January 2007 to 30 November 2017. Study selection was based on title and abstract. Full texts of potentially relevant articles were retrieved and assessed for inclusion by two reviewers. Subsequently, quality was assessed using the Newcastle-Ottawa Quality Assessment Scales for patient selection, comparability and assessment of outcomes. Two independent reviewers carried out study selection and data extraction according to Cochrane methods. Random-effect meta-analysis was performed using Review Manager software on all data (overall analysis), followed by subgroup analyses. OUTCOMES A total of 21 studies were included in the meta-analysis. A decreased probability of live birth following IVF was observed in obese (BMI ≥ 30 kg/m2) women when compared with normal weight (BMI 18.5–24.9 kg/m2) women: risk ratio (RR) (95% CI) 0.85 (0.82–0.87). Subgroups analyses demonstrated that prognosis was poorer when obesity was associated with polycystic ovary syndrome, while the oocyte origin (donor or non-donor) did not modify the overall interpretation. WIDER IMPLICATIONS Our meta-analysis clearly demonstrates that female obesity negatively and significantly impacts live birth rates following IVF. Whether weight loss can reverse this deleterious effect through lifestyle modifications or bariatric surgery should be further evaluated.

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Effectiveness of Hydrocolloid Dressings for Treating Pressure Ulcers in Adult Patients: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217881 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7881

Author(s):

Magdalena Sylwia Kamińska ◽

Anna Maria Cybulska ◽

Karolina Skonieczna-Żydecka ◽

Katarzyna Augustyniuk ◽

Elżbieta Grochans ◽

...

Keyword(s):

Systematic Review ◽

Pressure Ulcers ◽

Meta Analysis ◽

Random Effect ◽

Cochrane Collaboration ◽

Adult Patients ◽

Therapeutic Effects ◽

Study Selection ◽

Meta Analyses ◽

The Cochrane Collaboration

The aim of this study was to assess the effectiveness of hydrocolloid dressings in the treatment of grade I, II, III, and IV pressure ulcers in adult patients. We compared the therapeutic effects of hydrocolloids and alternative dressings in pressure ulcer treatment. We conducted a systematic review, using a literature search only in English, from database inception until 20 April 2020, to identify randomized trials comparing various types of dressings applied in the healing of pressure ulcers. The databases were PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The study selection was performed independently by two reviewers. Data were extracted based on the guidelines included in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The risk of bias in the included studies was assessed using a standardized critical appraisal instrument developed by the Cochrane Collaboration. Random-effect meta-analysis of data from three or more studies was performed using meta-analysis software (Comprehensive Meta-Analysis V3, Biostat, New Jersey, USA). A total of 1145 records were identified, of which 223 were qualified after further verification, of which eight were finally included in further analysis. Hydrocolloid dressings were not superior to control therapeutics (p = 0.839; Z = 0.203; CI 95%: 0.791–1.334). They were not associated with higher healing rates (p = 0.718; Z = 0.361; OR: 0.067; CI 95%: 0.297–0.431), nor did they decrease the incidence of adverse events compared with control therapeutics (p = 0.300; Z = −1.036; OR: 0.067; CI 95%: 0.394–1.333). In the above cases, Egger’s test also did not indicate publication bias (t value = 0.779, p = 0.465; t value = 1.198, p = 0.442; t value = 0.834, p = 0.465, respectively). The present meta-analysis shows that hydrocolloid dressings are not significantly better than alternative ones in the healing of pressure ulcers in adult patients.

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The Most Psychological Impacts of Coronavirus Epidemics: A Protocol for Systematic Review and Meta-Analysis

Iranian Journal of Psychiatry ◽

10.18502/ijps.v15i3.3818 ◽

2020 ◽

Author(s):

Parandis Pourdehghan ◽

Seyed-Ali Mostafavi

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Psychological Problems ◽

Cochrane Library ◽

Prevalence Rates ◽

Study Selection ◽

Psychological Stressor ◽

The Cochrane Library

Objective: The Coronavirus disease 2019 (COVID-19) is a considerable psychological stressor that has a significant impact on every facet of people’s life. Since 2002 that the first Coronavirus epidemic has emerged, many pieces of researches have indicated several psychological problems during this period. In circumstances such as COVID-19, researchers could deploy previous resources to identify the most prevalent psychological effects of Coronavirus diseases. We aim to systematically review and quantitatively assess the psychological problems during Coronavirus epidemics to identify the most prevalent psychological problems. Method: A systematic review of the literature will be conducted on psychological problems during previous and the new Coronavirus epidemics. Electronic databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, PsycINFO/ProQuest, Scopus, and Google Scholar will be systematically searched using predefined search terms to identify relevant articles published from January 1, 2002 to June 20, 2020. Two authors independently identify papers that reported the prevalence rates of the psychological problems during Coronavirus outbreaks. The outcomes will include the most prevalent psychological problems during Coronavirus outbreaks. To ensure we have gathered all the evidence, we will conduct another search on the specific psychological problems revealed in the previous search. Study selection will follow the Cochrane library guideline. Afterward, data synthesis will be performed via the meta-analysis of the prevalence rates using the random effect model. Conclusion: The findings can allow identifying the most prevalent psychological problems since the first Coronavirus epidemic in 2002. This can help health policymakers and clinicians to be informed of the priorities of the psychological problems related to COVID-19.

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Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-030266 ◽

2020 ◽

Vol 10 (1) ◽

pp. e030266 ◽

Cited By ~ 2

Author(s):

Parichehr Shamsrizi ◽

Beryl Primrose Gladstone ◽

Elena Carrara ◽

Dora Luise ◽

Andrea Cona ◽

...

Keyword(s):

Systematic Review ◽

Infection Type ◽

Meta Analysis ◽

Random Effect ◽

Current Evidence ◽

Attributable Mortality ◽

Esbl Production ◽

Non Invasive ◽

Extended Spectrum ◽

The Impact

ObjectiveTo assess the variation of effect estimates in the analysis of mortality and length of stay (LOS) in patients with infections caused by extended-spectrum beta-lactamase (ESBL)-producingEnterobacteriaceae.DesignSystematic review and meta-analysisMethodsLiterature search for clinical studies from 1 January 1960 to 1 October 2018 was conducted in PubMed. Primary outcomes were risk ratios (RRs) of all-cause and attributable mortality and weighted mean differences (WMDs) in LOS in patients with bloodstream infections (BSIs) and non-invasive infections. Any change in the effect estimates was assessed by grouping studies according to design, setting, economy-based country classification, reporting period, microbiological aetiology, infection type and adjustment for appropriateness of empirical treatment. The impact of ESBL production was calculated using random-effect meta-analysis and heterogeneity was evaluated by I2statistics and metaregression.ResultsEighty-four studies including 22 030 patients and 149 outcome measures were included in the meta-analysis. Most studies were retrospective cohorts from high-income countries, providing unadjusted estimates. ESBL production in patients with BSIs (56 studies) increased the RR for all-cause mortality by a factor of 1.70 (95% CI 1.52 to 1.90; p<0.001), attributable mortality (16 studies) by 1.75 (95% CI 1.448 to 2.108; p<0.001) and WMD in the intensive care unit by 3.07 days (95% CI 1.61 to 4.54; p<0.001). WMD in hospital LOS was significantly higher in BSIs (4.41 days; 95% CI 3.37 to 5.46; p<0.001) and non-invasive (2.19 days; 95% CI 1.56 to 2.81; p<0.001). Subgroup analyses showed variation of estimates by study design, population, strain and assessment of appropriateness of empiric treatment. High heterogeneity was observed in all analyses.ConclusionsCurrent evidence of the clinical burden of infections caused by ESBL-producing bacteria is highly heterogeneous and based mainly on unadjusted estimates derived from retrospective studies. Despite these limitations, ESBL production in strains causing BSIs seems associated with higher all-cause and attributable mortality and longer hospitalisation.

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