scholarly journals 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

2018 ◽  
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.

scholarly journals Association Between Out-of-Hour Admission and Short- and Long-Term Mortality in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Yan Yu ◽  
Bo-Wen Zhao ◽  
Lan Ma ◽  
Xiao-Ce Dai
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Publication Bias ◽  
Meta Analysis ◽  
Short Term ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
Long Term Mortality

Objectives: Out-of-hour admission (on weekends, holidays, and weekday nights) has been associated with higher mortality in patients with acute myocardial infarction (AMI). We conducted a meta-analysis to verify the association between out-of-hour admission and mortality (both short- and long-term) in AMI patients.Design: This Systematic review and meta-analysis of cohort studies.Data Sources: PubMed and EMBASE were searched from inception to 27 May 2021.Eligibility Criteria for Selected Studies: Studies of any design examined the potential association between out-of-hour admission and mortality in AMI.Data Extraction and Synthesis: In total, 2 investigators extracted the data and evaluated the risk of bias. Analysis was conducted using a random-effects model. The results are shown as odds ratios [ORs] with 95% confidence intervals (CIs). I2 value was used to estimate heterogeneity. Grading of Recommendations Assessment, Development, and Evaluation was used to assess the certainty of the evidence.Results: The final analysis included 45 articles and 15,346,544 patients. Short-term mortality (defined as either in-hospital or 30-day mortality) was reported in 42 articles (15,340,220 patients). Out-of-hour admission was associated with higher short-term mortality (OR 1.04; 95%CI 1.02–1.05; I2 = 69.2%) but there was a significant statistical indication for publication bias (modified Macaskill's test P &lt; 0.001). One-year mortality was reported in 10 articles (1,386,837 patients). Out-of-hour admission was also associated with significantly increased long-term mortality (OR 1.03; 95%CI 1.01–1.04; I2 = 66.6%), with no statistical indication of publication bias (p = 0.207). In the exploratory subgroup analysis, the intervention effect for short-term mortality was pronounced among patients in different regions (p = 0.04 for interaction) and socio-economic levels (p = 0.007 for interaction) and long-term mortality was pronounced among patients with different type of AMI (p = 0.0008 for interaction) or on different types of out-to-hour admission (p = 0.006 for interaction).Conclusion: Out-of-hour admission may be associated with an increased risk of both short- and long-term mortality in AMI patients.Trial Registration: PROSPERO (CRD42020182364).

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Qing Quan ◽  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Short Term Mortality ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS. Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and higher long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). According to our subgroup analysis, there is still has a statistical significance for LMR to predict long-term mortality/MACE in any subgroups. Conclusions: This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun ◽  
Xiao-Qing Quan
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Short Term Mortality ◽  
Long Term Mortality

Abstract The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS.Methods A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to August 1, 2019.Results A total of 5 studies comprising 3122 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (odds ratio [OR] = 2.61, 95% confidence interval [CI]: 1.15–5.94, P = 0.022) and higher long-term mortality/MACE (OR = 2.10, 95% CI: 1.06–4.19, P = 0.035). According to our subgroup analysis, there still has a statistical significance for LMR predict short-term mortality/MACE in lager sample size researches (≥600, OR = 3.50, 95% CI: 1.84–6.67, p < 0.001),Turkey researches (OR = 4.16, 95% CI: 2.32–7.46, p < 0.001), younger patients researches (< 62, OR = 3.76, 95% CI: 2.29–6.18, p < 0.001).Conclusions This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in patients with ACS.

scholarly journals QT prolongation predicts short-term mortality independent of comorbidity

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1254-1260 ◽  
Author(s):  
Charlotte Gibbs ◽  
Jacob Thalamus ◽  
Doris Tove Kristoffersen ◽  
Martin Veel Svendsen ◽  
Øystein L Holla ◽  
...  
Keyword(s):  
Main Diagnosis ◽  
Short Term ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Comorbidity Index ◽  
Short And Long Term ◽  
Mortality Hazard Ratio ◽  
Long Term Mortality

Abstract Aims A prolonged corrected QT interval (QTc) ≥500 ms is associated with high all-cause mortality in hospitalized patients. We aimed to explore any difference in short- and long-term mortality in patients with QTc ≥500 ms compared with patients with QTc <500 ms after adjustment for comorbidity and main diagnosis. Methods and results Patients with QTc ≥500 ms who were hospitalized at Telemark Hospital Trust, Norway between January 2007 and April 2014 were identified. Thirty-day and 3-year all-cause mortality in 980 patients with QTc ≥500 ms were compared with 980 patients with QTc <500 ms, matched for age and sex and adjusting for Charlson comorbidity index (CCI), previous admissions, and main diagnoses. QTc ≥500 ms was associated with increased 30-day all-cause mortality [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.38–2.62; P < 0.001]. There was no significant difference in mortality between patients with QTc ≥500 ms and patients with QTc <500 ms who died between 30 days and 3 years; 32% vs. 29%, P = 0.20. Graded CCI was associated with increased 3-year all-cause mortality (CCI 1–2: HR 1.62, 95% CI 1.34–1.96; P < 0.001; CCI 3–4: HR 2.50, 95% CI 1.95–3.21; P < 0.001; CCI ≥5: HR 3.76, 95% CI 2.85–4.96; P < 0.001) but was not associated with 30-day all-cause mortality. Conclusion QTc ≥500 ms is a powerful predictor of short-term mortality overruling comorbidities. QTc ≥500 ms also predicted long-term mortality, but this effect was mainly caused by the increased short-term mortality. For long-term mortality, comorbidity was more important.

Short‐ and long‐term mortality after bariatric surgery: A systematic review and meta‐analysis

2017 ◽  
Vol 19 (9) ◽  
pp. 1223-1232 ◽  
Author(s):  
Luís Cardoso ◽  
Dírcea Rodrigues ◽  
Leonor Gomes ◽  
Francisco Carrilho
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Meta Analysis ◽  
Short And Long Term ◽  
Long Term Mortality

scholarly journals SHORT AND LONG-TERM MORTALITY AFTER STEMI VERSUS NON-STEMI: A SYSTEMATIC REVIEW AND META-ANALYSIS

2013 ◽  
Vol 61 (10) ◽  
pp. E96 ◽  
Author(s):  
Aude Marceau ◽  
Jean-Michel Samson ◽  
Nathalie Laflamme ◽  
Stéphane Rinfret
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Short And Long Term ◽  
Long Term Mortality

scholarly journals Comparison of surgical indications and short- and long-term complications in 56 cats undergoing perineal, transpelvic or prepubic urethrostomy

2020 ◽  
pp. 1098612X2095903
Author(s):  
Maheeka Seneviratne ◽  
Polina Stamenova ◽  
Karla Lee
Keyword(s):  
Short Term ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
Urethral Lesion ◽  
Urethral Rupture ◽  
Complications And Mortality ◽  
Long Term Mortality

Objectives The aim of this study was to compare indications, complications and mortality rates for perineal urethrostomy (PU), transpelvic urethrostomy (TPU) and prepubic urethrostomy (PPU). Methods A retrospective review of, and follow-up owner questionnaire for, cats undergoing urethrostomy between 2008 and 2018, at a single referral hospital, were performed. Results Fifty-six cats underwent urethrostomy (PU, n = 37; TPU, n = 8; PPU, n = 11). The presenting problem was significantly associated with urethrostomy technique ( P <0.001). For PU cats, feline idiopathic cystitis (FIC; n = 21 [56.7%]) was the most common problem, whereas for PPU cats, trauma (n = 9 [81.8%]) was most common ( P <0.001). Urethrostomy technique was associated with imaging diagnosis ( P <0.001) of the urethral lesion. Most PU cats had no diagnostic imaging lesion (n = 15 [40.5%]) or obstructive calculi or clots (n = 10 [27.0%]), and all PPU cats had urethral rupture. Ten (90.9%) PPU cats had a pelvic lesion, while 21 (56.7%) PU cats had a penile lesion. TPU cats had a range of presenting problems and imaging diagnoses. Short- and long-term complications were reported in 33/55 (60.0%) and 11/30 (36.7%) cats, respectively. The number of cats with long-term complications was greater among PPU cats ( P = 0.02). Short-term dermatitis ( P = 0.019) and long-term incontinence ( P = 0.01) were associated with PPU. Short-term mortality was 5.6% and long-term mortality was 13.3%; both were independent of urethrostomy technique. Quality of life post-urethrostomy, across all techniques, was graded as good by 93% of owners. Conclusions and relevance In this study, PU was the most common feline urethrostomy technique indicated for FIC. Short-term urethrostomy complications are common, irrespective of urethrostomy technique. Long-term complications are less frequent but more common with PPU.

scholarly journals Prognostic value of new-onset right bundle-branch block in acute myocardial infarction patients: a systematic review and meta-analysis

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4497 ◽  
Author(s):  
Juntao Wang ◽  
Hongxing Luo ◽  
Chunling Kong ◽  
Shujuan Dong ◽  
Jingchao Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Lower Risk ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Short Term ◽  
Bundle Branch Block ◽  
Short Term Mortality ◽  
Long Term Mortality ◽  
New Onset

Background Patients with acute myocardial infarction (AMI) and bundle-branch block have poor prognoses. The new European Society of Cardiology guideline suggests a primary percutaneous coronary intervention strategy when persistent ischemic symptoms occur in patients with persistent ischemic symptoms and right bundle-branch block (RBBB), but the level of evidence is not high. In fact, the presence of RBBB may lead to the misdiagnosis of transmural ischemia and mask the early diagnosis of ST-elevation myocardial infarction. Moreover, new-onset RBBB is occasionally caused by AMI. Our study aims to investigate the prognostic value of new-onset RBBB in AMI. Methods and Results We conducted a meta-analysis of studies to evaluate the prognostic value of RBBB in AMI patients. Of 914 primary records, five studies and 874 MI patients were included for meta-analysis. Compared with previous RBBB, AMI patients with new-onset RBBB had a higher risk of long-term mortality (RR, 1.66, 95% CI [1.31–2.09], I2 = 0.0%, p = 0.000, n = 2), ventricular arrhythmia (RR, 4.86, 95% CI [2.10–11.27], I2 = 0.0%, p = 0.000, n = 3), and cardiogenic shock (RR, 2.76, 95% CI [1.66–4.59], I2 = 0.0%, p = 0.000, n = 3), but a lower risk of heart failure (RR, 0.66, 95% CI [0.52–0.85], I2 = 2.50%, p = 0.001, n = 4). Compared with AMI patients with new-onset permanent RBBB, patients with new-onset transient RBBB had a lower risk of short-term mortality (RR, 0.20, 95% CI [0.11–0.37], I2 = 44.1%, p = 0.000, n = 4). Conclusion New-onset RBBB is likely to increase long-term mortality, ventricular arrhythmia, and cardiogenic shock, but not heart failure in AMI patients. AMI patients with new-onset transient RBBB have a lower risk of short-term mortality than those with new-onset permanent RBBB. Revascularization therapies should be considered when persistent ischemic symptoms occur in patients with RBBB, especially new-onset RBBB.

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