Dietary restriction of rodents decreases aging rate without affecting initial mortality rate - a meta-analysis

Background: In recent decades, liver transplantation (LTx) has increased the survival and quality of life of patients with end-stage organ failure. Unfortunately, LTx is limited due to the shortage of donors. A lot of effort is put into finding new ways to reduce ischemia-reperfusion injury (IRI) in liver grafts to increase the number of suitable organs procured from expanded-criteria donors (ECD). The aim of this study was to systematically review the literature reporting LTx outcomes when using ischemic preconditioning (IPC) or remote ischemic preconditioning (RIPC) to reduce IRI in liver grafts. Methods: A literature search was performed in the MEDLINE, Web of Science, and EMBASE databases. The following combination was used: “Liver” OR “Liver Transplantation” AND “Ischemic preconditioning” OR “occlusion” OR “clamping” OR “Pringle.” The following outcome data were retrieved: the rates of graft primary nonfunction (PNF), retransplantation, graft loss, and mortality; stay in hospital and the intensive care unit; and postoperative serum liver damage parameters. Results: The initial search retrieved 4,522 potentially relevant studies. After evaluating 17 full-text articles, a total of 9 randomized controlled trials (RCTs) were included (7 IPC and 2 RIPC studies) in the qualitative synthesis; the meta-analysis was only performed on the data from the IPC studies. RIPC studies had considerable methodological differences. The meta-analysis revealed the beneficial effect of IPC when comparing postoperative aspartate aminotransferase (AST) corresponding to a statistically lower mortality rate in the IPC group (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27–0.98; p = 0.04). Conclusion: IPC lowers postoperative AST levels and reduces the mortality rate; however, data on the benefits of RIPC are lacking.

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Clinical outcomes of cancer patients with COVID-19: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18600 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18600-e18600

Author(s):

Maryam Alasfour ◽

Salman Alawadi ◽

Malak AlMojel ◽

Philippos Apolinario Costa ◽

Priscila Barreto Coelho ◽

...

Keyword(s):

Mortality Rate ◽

Cancer Patients ◽

Clinical Outcomes ◽

Meta Analysis ◽

Small Sample ◽

Prediction Intervals ◽

Invasive Ventilation ◽

Newcastle Ottawa Scale ◽

Small Sample Sizes ◽

Meta Analyses

e18600 Background: Patients with coronavirus disease 2019 (COVID-19) and cancer have worse clinical outcomes compared to those without cancer. Primary studies have examined this population, but most had small sample sizes and conflicting results. Prior meta-analyses exclude most US and European data or only examine mortality. The present meta-analysis evaluates the prevalence of several clinical outcomes in cancer patients with COVID-19, including new emerging data from Europe and the US. Methods: A systematic search of PubMED, medRxiv, JMIR and Embase by two independent investigators included peer-reviewed papers and preprints up to July 8, 2020. The primary outcome was mortality. Other outcomes were ICU and non-ICU admission, mild, moderate and severe complications, ARDS, invasive ventilation, stable, and clinically improved rates. Study quality was assessed through the Newcastle–Ottawa scale. Random effects model was used to derive prevalence rates, their 95% confidence intervals (CI) and 95% prediction intervals (PI). Results: Thirty-four studies (N = 4,371) were included in the analysis. The mortality prevalence rate was 25.2% (95% CI: 21.1–29.7; 95% PI: 9.8-51.1; I 2 = 85.4), with 11.9% ICU admissions (95% CI: 9.2-15.4; 95% PI: 4.3-28.9; I 2= 77.8) and 25.2% clinically stable (95% CI: 21.1-29.7; 95% PI: 9.8-51.1; I 2 = 85.4). Furthermore, 42.5% developed severe complications (95% CI: 30.4-55.7; 95% PI: 8.2-85.9; I 2 = 94.3), with 22.7% developing ARDS (95% CI: 15.4-32.2; 95% PI: 5.8-58.6; I 2 = 82.4), and 11.3% needing invasive ventilation (95% CI: 6.7-18.4; 95% PI: 2.3-41.1; I 2 = 79.8). Post-follow up, 49% clinically improved (95% CI: 35.6-62.6; 95% PI: 9.8-89.4; I 2 = 92.5). All outcomes had large I 2 , suggesting high levels of heterogeneity among studies, and wide PIs indicating high variability within outcomes. Despite this variability, the mortality rate in cancer patients with COVID-19, even at the lower end of the PI (9.8%), is higher than the 2% mortality rate of the non-cancer with COVID-19 population, but not as high as what other meta-analyses conclude, which is around 25%. Conclusions: Patients with cancer who develop COVID-19 have a higher probability of mortality compared to the general population with COVID-19, but possibly not as high as previous studies have shown. A large proportion of them developed severe complications, but a larger proportion recovered. Prevalence of mortality and other outcomes published in prior meta-analyses did not report prediction intervals, which compromises the clinical utilization of such results.

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Critical illness myopathy in intensive care setting

QJM ◽

10.1093/qjmed/hcab086.044 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mostafa K Fouad ◽

Ashraf M Hazem ◽

Kareem M Elnaghy

Keyword(s):

Critical Illness ◽

Mortality Rate ◽

Usual Care ◽

Usual Care Group ◽

Fixed Effects ◽

Meta Analysis ◽

Care Group ◽

Fixed Effects Model ◽

Analysis Study ◽

Number Of Patients

Abstract Aim of the Work to provide cumulative data about the efficacy and safety of neuro-muscular electrical stimulation (NMES) combined with usual care (UC) versus usual care alone in ICU patients with Critical Illness Myopathy (CIM). Methodology The current systematic review was done on studies published between 2009 and 2019. The total number of patients in all the included studies was 1259 patients; 652 in NMES group, and 607 in UC group. Our data were divided into two groups: NMES (652 patients), and UC (607 patients). Metaanalysis study was done on 11 studies which described and compared the 2 different techniques for treatment of CIM; with overall number of patients (N = 1259). Results Regarding 1ry outcome measures, we found 8 studies reported critical Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and the overlap, critical care setting MRC scale for muscle strength, with total number of patients (N = 968). The random-effects model of the meta-analysis study showed non-significant difference in mean MRC scale in NMES group compared to usual care group (p > 0.05). We also found 11 studies reported ICU stay with total number of patients (N = 1259). The random-effects model of the meta-analysis study showed nonsignificant difference in mean ICU stay in NMES group compared to usual care group (p > 0.05). We also found only 2 studies reported SF-36 scale for quality of life, with total number of patients (N = 270). The fixed-effects model of the metaanalysis study showed highly significant decrease in mean SF-36 scale in NMES group compared to usual care group (p = 0.003). Regarding 2ry outcome measure, we found 3 studies reported CIM incidence with total number of patients (N = 394). The fixed-effects model of the meta-analysis study showed marked decrease in CIM incidence in NMES group compared to usual care group, but not reaching statistical significance (p > 0.05). We also found 9 studies reported mortality rate with total number of patients (N = 1044). The fixed-effects model of the meta-analysis study showed non-significant difference in mortality rate in NMES group compared to usual care. Our systematic review and meta-analysis showed that NMES combined with usual care was not associated with significant differences in global muscle strength, ICU stay, quality of life score, CIM incidence and mortality rate in comparison with usual care alone in critically ill patients. Conclusion NMES is not superior to usual care in management of CIM. Usual care remains the mainstay of management of CIM with significant better outcomes, in addition to preventive measures as early aggressive treatment of sepsis and MOF, blood glucose control, optimizing certain drugs use, early enteral nutrition, maintaining water, electrolyte and acidbase balance.

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Intracranial Hypertension After Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-analysis of Prevalence and Mortality Rate

Neurocritical Care ◽

10.1007/s12028-018-0658-x ◽

2018 ◽

Vol 31 (1) ◽

pp. 176-187 ◽

Cited By ~ 7

Author(s):

Daniel Agustín Godoy ◽

Rafael A. Núñez-Patiño ◽

Andres Zorrilla-Vaca ◽

Wendy C. Ziai ◽

J. Claude Hemphill

Keyword(s):

Systematic Review ◽

Mortality Rate ◽

Intracerebral Hemorrhage ◽

Intracranial Hypertension ◽

Meta Analysis ◽

Spontaneous Intracerebral Hemorrhage

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Efficacy of mesenchymal stem cell therapy for sepsis: A meta-analysis of preclinical studies

10.21203/rs.3.rs-15951/v2 ◽

2020 ◽

Author(s):

xueyi sun ◽

xianfei ding ◽

huoyan liang ◽

xiaojuan zhang ◽

shaohua liu ◽

...

Keyword(s):

Stem Cell ◽

Mortality Rate ◽

Animal Models ◽

Mesenchymal Stem Cell ◽

Fixed Effects ◽

Meta Analysis ◽

Experimental Models ◽

Lower Mortality ◽

Cochrane Library ◽

Fixed Effects Model

Abstract Background: Multiple studies have reported that mesenchymal stem cell (MSC) therapy has beneficial effects in experimental models of sepsis. However, this finding remains inconclusive. This study was performed to systematically determine the connection between MSC therapy and mortality in sepsis animal models by pooling and analyzing data from newly published studies. Methods: A detailed search of related studies from 2009 to 2019 was conducted in four databases, including MEDLINE, EMBASE, Cochrane Library, and Web of Science. After browsing and filtering out articles that met the inclusion criteria for statistical analysis, the inverse variance method of the fixed effects model was used to calculate the pooled odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Twenty-nine animal studies, including 1,266 animals, were identified. None of the studies were judged to have a low risk of bias. The meta-analysis demonstrated that MSC therapy was related to a significantly lower mortality rate (OR 0.29, 95% CI 0.22–0.38, P <0.001). Subgroup analyses performed based on the MSC injection dose (<1.0 × 10 6 cells, OR=0.33, 95% CI 0.20–0.56, P <0.001; 1.0 × 10 6 cells, OR=0.24, 95% CI 0.16–0.35, P <0.001) and injection time (<1 hour, OR=0.24, 95% CI 0.13–0.45, P <0.001; 1 hour, OR=0.28, 95% CI 0.17–0.46, P <0.001) demonstrated that treatment with MSCs significantly reduced the mortality rate of animals with sepsis. Conclusion: This up-to-date meta-analysis showed a connection between MSC therapy and lower mortality in sepsis animal models, supporting the potential therapeutic effect of MSC treatment in future clinical trials. The results in this study contradict a previous meta-analysis with regards to the ideal dose of MSC therapy. Thus, further research is required to support these findings.

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The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics

Journal of Medical Research and Innovation ◽

10.32892/jmri.243 ◽

2021 ◽

Vol 5 (1) ◽

pp. e000243

Author(s):

Rhiannon Olivia Moody

Keyword(s):

Mortality Rate ◽

Klebsiella Pneumoniae ◽

Therapeutic Option ◽

Meta Analysis ◽

Mortality Rates ◽

Resistant Bacteria ◽

Cure Rate ◽

Treatment Regimens ◽

Hospitalised Patients ◽

Microbiological Cure

Introduction: Infection with the bacteria carpamenease-producing Klebsiella pneumoniae represents a significant cause of mortality in hospitalised patients. These multidrug resistant bacteria are resistant to currently used antibiotics as a result of carbapenemase production. Dual carbapenem therapy has been proposed as a valid therapeutic option, this therapy combines two carbapenem antibiotics, with one acting as a suicide inhibitor allowing the subsequent carbapenem to exert a bactericidal effect. Aim: The aim of this meta-analysis was to determine if dual carbapenem therapy had a significant effect on mortality rate and microbiological cure rate in patients diagnosed with carbapenemase-producing Klebsiella pneumoniae infections in comparison to standard antibiotic therapies. Methods: The search terms “(dual OR double) carbapenem (therapy OR treatment) AND klebsiella pneumoniae” were used to search databases and inclusion and exclusion criteria were applied to retrieved papers, a total of seven studies were identified for inclusion in the meta-analysis. The quality of included studies was assessed using the cochrane tool for risk of bias assessment and funnel plots were produced to determine the influence of publication bias. A random effects model was used to assess the outcomes; mortality rate and microbiological cure rate. Results and Conclusion: Dual carbapenem therapy had a time dependent effect on patient mortality rates. Dual carbapenem therapy significantly lowered mortality rates in patients in comparison to standard antibiotic therapy, especially in comparison to monotherapy treatment regimens. Additionally, dual carbapenem therapy significantly improved microbiological cure rate in patients when compared to standard antibiotic treatment regimens demonstrating the possible clinical applications of a dual carbapenem antibiotic regimen in the treatment of carbapenemase-producing Klebsiella pneumoniae infections.

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762. The Mortality Rate of Electroconvulsive Therapy: Results from a Systematic Review and Meta-Analysis

Biological Psychiatry ◽

10.1016/j.biopsych.2017.02.829 ◽

2017 ◽

Vol 81 (10) ◽

pp. S309-S310

Author(s):

Nina Torring ◽

Sohag N Sanghani ◽

Georgios Petrides ◽

Charles H Kellner ◽

Soren Dinesen Ostergaard

Keyword(s):

Systematic Review ◽

Mortality Rate ◽

Electroconvulsive Therapy ◽

Meta Analysis

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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.353 ◽

2020 ◽

Vol 41 (3) ◽

pp. 342-354 ◽

Cited By ~ 1

Author(s):

Sofia Karagiannidou ◽

Christos Triantafyllou ◽

Theoklis E. Zaoutis ◽

Vassiliki Papaevangelou ◽

Nikolaos Maniadakis ◽

...

Keyword(s):

Systematic Review ◽

Mortality Rate ◽

Length Of Stay ◽

Healthcare Cost ◽

Meta Analysis ◽

Random Effect ◽

Bloodstream Infections ◽

Attributable Mortality ◽

Study Selection ◽

Critical Appraisal Skills

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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