scholarly journals Risk factors for mental illness in adults with atopic eczema or psoriasis: protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038324
Author(s):  
Elizabeth I Adesanya ◽  
Yochai Schonmann ◽  
Joseph F Hayes ◽  
Rohini Mathur ◽  
Amy R Mulick ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Mental Illness ◽  
Atopic Eczema ◽  
Skin Diseases ◽  
Grey Literature ◽  
Evaluation Framework ◽  
Mental Illnesses ◽  
Cochrane Library ◽  
Increased Risk

IntroductionEvidence indicates that people with the common inflammatory skin diseases atopic eczema or psoriasis are at increased risk of mental illness. However, the reasons for the relationship between skin disease and common mental disorders (ie, depression and anxiety) or severe mental illnesses (ie, schizophrenia, bipolar disorder and other psychoses) are unclear. Therefore, we aim to synthesise the available evidence regarding the risk factors for mental illness in adults with atopic eczema or psoriasis.Methods and analysisWe will conduct a systematic review of randomised controlled trials, cohort, case–control and cross-sectional studies. We will search the following databases from inception to March 2020: Medline, Embase, Global Health, Scopus, the Cochrane Library, Web of Science, Base, PsycInfo, the Global Resource of Eczema Trials, and the grey literature databases Open Grey, PsycExtra and the New York Academy of Medicine Grey Literature Report. We will also search the bibliographies of eligible studies and relevant systematic reviews to identify additional relevant studies. Citation searching of large summary papers will be used to further identify relevant publications. Two reviewers will initially review study titles and abstracts for eligibility, followed by full text screening. We will extract data using a standardised data extraction form. We will assess the risk of bias of included studies using the Quality in Prognosis Studies tool. We will synthesise data narratively, and if studies are sufficiently homogenous, we will consider a meta-analysis. We will assess the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework.Ethics and disseminationEthical approval is not required for a systematic review. Results of the review will be published in a peer-reviewed journal and disseminated through conferences.PROSPERO registration numberCRD42020163941.

scholarly journals Associations of Loneliness and Social Isolation with Cardiovascular and Metabolic Health: a Systematic Review and Meta-analysis protocol

2019 ◽  
Author(s):  
Adriano Winterton ◽  
Linn Rødevand ◽  
Lars T. Westlye ◽  
Nils Eiel Steen ◽  
Ole A. Andreassen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Mental Illness ◽  
Social Isolation ◽  
Meta Analysis ◽  
Grey Literature ◽  
Metabolic Risk Factors ◽  
Mental Illnesses ◽  
Special Focus ◽  
Metabolic Risk

AbstractBackground: A growing number of studies suggest that social isolation and loneliness are associated with premature mortality and are more prevalent among people with mental illness than in the general population, outlining many potential paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between loneliness, social isolation and established cardiovascular/metabolic risk factors and disorders, especially in severe mental illness, and to account for potential heterogeneity in the literature. Methods/design: Studies that report measures of loneliness and/or social isolation along with cardiovascular/metabolic risk factors will be identified. PubMed, EMBASE (through Ovid SP), Scopus and PsycINFO (through Ovid SP) will be searched, along with citation lists of retrieved articles and the Cochrane Database of Systematic Reviews. Grey literature will be searched using Google Scholar. Data will be extracted from eligible studies for a random-effects meta-analysis. For each study, a summary effect size, heterogeneity, risk of bias, publication bias, and the effect of categorical and continuous moderator variables will be determined.Discussion: This proposed systematic review and meta-analysis will identify and synthesize evidence to determine if there is an association between loneliness, social isolation and cardiovascular/metabolic risk factors, with a special focus on severe mental illnesses. The results will help determine links and promising avenues of further research.

scholarly journals Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255488
Author(s):  
Ritbano Ahmed ◽  
Hassen Mosa ◽  
Mohammed Sultan ◽  
Shamill Eanga Helill ◽  
Biruk Assefa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Birth Asphyxia ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Chronic Hypertension ◽  
Factors Associated ◽  
Pooled Prevalence

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

scholarly journals Protocol for a systematic review of reviews evaluating effectiveness of mass media interventions for prevention and control of non-communicable diseases

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e032611
Author(s):  
Gursimer Jeet ◽  
J S Thakur ◽  
Shankar Prinja ◽  
Meenu Singh ◽  
Ria Nangia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Mass Media ◽  
Grey Literature ◽  
Communicable Diseases ◽  
Controlled Vocabulary ◽  
Cochrane Library ◽  
Non Communicable Diseases ◽  
Low Middle Income Countries ◽  
Media Interventions

IntroductionTimely interventions are required in order to change unhealthy lifestyles because if continued for a prolonged period of time, these become risk factors for non-communicable diseases (NCDs). Education through mass media is an important factor in bringing out the behavioural change which may get missed in community-based interventions due to their limited reach. Many countries engage in mass media interventions, however, the nature of interventions and their effectiveness differs. We, therefore, describe the protocol of a systematic review to evaluate the effectiveness of the mass media interventions to reduce the risk of NCDs in the general population and compare the differences in effectiveness estimates across low/middle-income countries and developed countries.Methods and analysisWe will search The Cochrane Library, Database of Abstracts of Reviews of Effectiveness, PubMed, Excerpta Medica Database limited to publications since 2000 to October 2019. Specific terms for the search strategy will be piloted as database-controlled vocabulary in the databases searched. The searches will include variations of the following terms: mass media, mass communication, campaign, publicity and terms for types of media, that is, print media, mobile, digital media, social media and broadcast. Study designs to be included will be systematic reviews followed by grey literature and other good quality reviews identified. The primary outcome of effectiveness will be the percentage change in population having different behavioural risk factors. In addition, mean overall change in levels of several physical or biochemical parameters will be studied as secondary outcomes.Ethics and disseminationThe review is being done under the doctoral research which has been approved by the Institute Ethics Committee of the Post Graduate Institute of Medical Education and Research Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant conferences and meetings.PROSPERO registration numberCRD42016048013

scholarly journals Looking beyond the obvious: a critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world

2021 ◽  
Author(s):  
Rasha R Bayoumi ◽  
Jacky Boivin ◽  
Human M Fatemi ◽  
Lisa Hurt ◽  
Gamal I Serour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Global Health ◽  
Neonatal Death ◽  
Cochrane Library ◽  
Reproductive Process ◽  
Increased Risk ◽  
Fertility Problems ◽  
Meta Analyses ◽  
The Impact

Background: Well-established risk factors for fertility problems such as smoking have been included in fertility awareness efforts globally. However, these efforts neglect risks that women in low and middle-income countries (LMIC) face. Objective: To address this gap, we identified eight risk factors affecting women in LMIC and the aim of the current review was to estimate the impact of these risks on fertility. Methods: We conducted systematic reviews and where data was available meta-analyses. We searched Medline, Embase, Cochrane library, regional databases and key organizational websites (1946-June 2016, updated January 2018, latest update taking place in 2021). Two researchers screened and extracted data independently. We included all study designs that assessed exposure to risk in clinical or community-based samples and excluded studies without control groups. The outcome of interest was fertility problems (inability to achieve pregnancy or live birth and neonatal death). We calculated pooled effect estimates from reported effect sizes or raw data. We assessed study quality using the Newcastle-Ottawa Scale. We registered the review with PROSPERO, registration number CRD42016048497. Results: We identified 2,418 studies and included 61 (57 in meta-analyses). Results revealed a nine-fold increased risk of inability to become pregnant in genital tuberculosis (OR 8.91, CI 1.89-42.12) and almost threefold in HIV (OR 2.93, CI 1.95-4.42) and bacterial vaginosis (OR 2.81, CI 1.85-4.27). A twofold increased risk of tubal-factor infertility in Female Genital Mutilation/Cutting [Type II/III] (OR 2.06, CI 1.03-4.15) and increased post-natal mortality in consanguinity (stillbirth, OR 1.28, CI 1.04-1.57; neonatal death, OR 1.57, CI 1.22-2.02). Strength and limitations: Reliability of results was bolstered by a rigorous systematic review methodology that is replicable but limited by methodological shortcomings of the available primary studies and the small number of studies in each meta-analysis. Conclusions: The risk factors investigated appeared to impact the reproductive process through multiple biological, behavioural, and clinical pathways. Additionally, infection and pelvic inflammatory disease seemed to be common pathways for several risk factors. The complex multifactorial risk profile can be addressed by LMIC using a global health framework to determine which risk factors are significant to their populations and how to tackle them. The subsequent health promotion encompassing these relevant health indicators could translate into more prevention and effective early detection of fertility problems in LMIC. Finally, the findings of multifactorial risk reinforced the need to put fertility as an agenda in global health initiatives.

scholarly journals GRADING prognostic factors for severe and recurrent Clostridioides difficile infection: expected and unexpected findings. A systematic review.

2021 ◽  
Author(s):  
Tessel Meike van Rossen ◽  
Rogier E. Ooijevaar ◽  
Christina M.J.E. Vandenbroucke-Grauls ◽  
Olaf M. Dekkers ◽  
Ed J. Kuijper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Laboratory Data ◽  
Final Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Clostridioides Difficile Infection

Background Clostridioides difficile infection (CDI), its subsequent recurrences (rCDI), and severe CDI (sCDI) provide a significant burden for both patients and the healthcare system. Treatment consists of oral antibiotics. Fidaxomicin, bezlotoxumab and fecal microbiota transplantion (FMT) reduce the number of recurrences compared to vancomycin, but are more costly. Identifying patients diagnosed with initial CDI who are at increased risk of developing sCDI/rCDI could lead to more cost-effective therapeutic choices. Objectives In this systematic review we aimed to identify clinical prognostic factors associated with an increased risk of developing sCDI or rCDI. Methods PubMed, Embase, Emcare, Web of Science and COCHRANE Library databases were searched from database inception through March, 2021. Study selection was performed by two independent reviewers on the basis of predefined selection criteria; conflicts were resolved by consensus. Cohort and case-control studies providing an analysis of clinical or laboratory data to predict sCDI/rCDI in patients ≥18 years diagnosed with CDI, were included. Risk of bias was assessed with the Quality in Prognostic Research (QUIPS) tool and the quality of evidence by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool, modified for prognostic studies. Overview tables of prognostic factors were constructed to assess the number of studies and the respective direction of an association (positive, negative, or no association). Results and conclusions 136 studies were included for final analysis. Higher age and the presence of multiple comorbidities were prognostic factors for sCDI. Identified risk factors for rCDI were higher age, healthcare-associated CDI, prior hospitalization, PPIs started during/after CDI diagnosis and previous rCDI. Some variables that were found as risk factors for sCDI/rCDI in previous reviews were not confirmed in the current review, which can be attributed to differences in methodology. Risk stratification for sCDI/rCDI may contribute to a more personalized and optimal treatment for patients with CDI.

scholarly journals Cues for different diagnostic patterns of interpersonal violence in a psychiatric sample: an observational study

2019 ◽  
Author(s):  
Dalila Talevi ◽  
Alberto Collazzoni ◽  
Alessandro Rossi ◽  
Paolo Stratta ◽  
Monica Mazza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Mood Disorder ◽  
Personality Disorders ◽  
Interpersonal Violence ◽  
Mental Illnesses ◽  
Health Concern ◽  
People With Mental Illness ◽  
Violent Behaviors ◽  
Increased Risk

Abstract Background. Interpersonal violence has increased as a health concern especially in the psychiatry practice over the last decades; nevertheless, most patients with stable mental illness do not present an increased risk of violence and a mental disorder is not a necessary or sufficient cause of violent behaviors. People with mental illness endorse more often a number of risk factors for violence that could confound this association, such as young age and male gender. The aim of this study was to investigate the effect of age, gender, and diagnosis on reported levels of interpersonal violence in a sample of people with severe mental illnesses. Methods. The sample was composed of 160 inpatients: 73 with psychosis, 53 with mood disorder and 34 with personality disorder. All patients enrolled in the study were assessed for experiences of victimization and perpetration of interpersonal violence using the Karolinska Interpersonal Violence Scale interview. Demographic variables were also collected. Results. Violence negatively correlated with age. Compared to males, females were exposed to higher degree of violence (for both victimizations in childhood and adulthood), whereas males were more involved in the perpetration of violence (only for perpetration in childhood). Among diagnoses, personality disorders are associated with higher levels of interpersonal violence. An interaction effect of gender and diagnosis was also observed for expression of violence in adulthood. Distinct patterns of interpersonal violence did emerge for the diagnostic entities with mood disorder showing a victimization pattern, personality disorders a perpetration pattern and psychoses a less defined pattern. Conclusions. The main finding is that psychoses, mood disorders and personality disorders have different patterns of violent experiences when combined with age and gender. This study offers a step towards a better understanding of the extent to which gender and age could affect violent behaviors. Moreover, study findings may increase the comprehension of the reason why some mental disorders, compared to others, are more associated with the risk of victimization or perpetration of violence. These patterns could have pathophysiological or pathoplastic meaning addressing clinical and diagnostic trajectories interacting with other intervening risk factors.

scholarly journals Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yeonkyung Park ◽  
Chiwon Ahn ◽  
Tae-Hyung Kim
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Environmental Risk ◽  
Environmental Risk Factors ◽  
Cochrane Library ◽  
Wood Dust ◽  
Increased Risk ◽  
Metal Dust

AbstractIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease of unknown cause. It has a high risk of rapid progression and mortality. We conducted a systematic review and meta-analysis to evaluate the risk factor of IPF. We searched Medline, Embase, and the Cochrane library from the earliest record to March, 2020. Case–control studies on occupational and environmental risk factors or on jobs with a risk of IPF were searched for. From 2490 relevant records, 12 studies were included. Any occupational or environmental exposure to metal dust (OR 1.83, 95% CI 1.15–2.91, I2 = 54%), wood dust (OR 1.62 5% CI 1.04–2.53, I2 = 5%) and pesticide (OR 2.07, 95% CI 1.24–3.45, I2 = 0%) were associated with an increased risk of IPF. Farming or agricultural work (OR 1.88, 95% CI 1.17–3.04, I2 = 67%) was also associated with an increased risk of IPF. Moreover, smoking increased IPF risk with an odds ratio of 1.39 (95% CI 1.01–1.91, I2 = 29%). In conclusion, metal dust, wood dust, pesticide, occupational history of farming or agriculture and ever smoking increased the risk of IPF.

scholarly journals Risk factors for postoperative stroke in adults patients with moyamoya disease: a systematic review with meta-analysis

2019 ◽  
Author(s):  
Wei Wei ◽  
Xin Chen ◽  
Yu Jun ◽  
Xuqin Li
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Postoperative Complications ◽  
Moyamoya Disease ◽  
Meta Analysis ◽  
Age At Onset ◽  
Adult Patients ◽  
Cochrane Library ◽  
Postoperative Stroke ◽  
Increased Risk

Abstract Background This systematic review and meta-analysis aimed to clarify the risk factors for postoperative stroke in adult patients with moyamoya disease (MMD). Methods We comprehensively searched MEDLINE/PubMed, Web of Science, and Cochrane Library for eligible published literature with regard to the risk factors and postoperative complications in adult patients with MMD. Statistical analysis was conducted using Stata version 12.0. Pooled odds ratio (OR) with 95% confidence interval (CI) were assessed for each risk factor. Results There were 8 studies encompassing 1649 patients who underwent surgery with MMD were selected for analysis. Preoperative ischemic event significantly increase the risk of postoperative stroke events (OR=1.40; 95%CI=1.02–1.92; P=0.039). PCA involvement correlate with an increased risk of post-infarction (OR=4.60; 95%CI=2.61–8.11; P=0.000). Compared to direct bypass, patients who underwent indirect bypass or combined bypass could significantly increase the risk of postoperative stroke events. (OR=1.17; 95%CI=1.03–1.33; p=0.017). MMD patients with diabetes were associated with an increased risk of postoperative stroke events (OR=4.02, 95% CI=1.59-10.16; p=0.003). MMD patients with hypertension, age at onset and male sex were not associated with an increased risk of postoperative stroke events (P>0.05). Conclusions This systematic review and meta-analysis indicated that preoperative ischemic events, PCA involvement and diabetes were independent risk factors for postoperative stroke in MMD patients. Therefore, in order to ensure the curative effect of patients with MMD, it is very necessary to detect these risk factors and prevent postoperative complications in time.

scholarly journals Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qian Hu ◽  
Shao-Jun Li ◽  
Qian-Ling Chen ◽  
Han Chen ◽  
Qiu Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Apgar Score ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Increased Risk ◽  
Critically Ill Neonates

Background and Objective: Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention.Methods: The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Studies published from the initiation of the database to November 19, 2020, were included. The quality of studies was assessed by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist. The meta-analysis was conducted with Stata 15 and drafted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.Results: Seventeen studies (five cohort studies, ten case-control studies, and two cross-sectional studies) were included in meta-analysis, with 1,627 cases in the case group and 5,220 cases in the control group. The incidence of AKI fluctuated from 8.4 to 63.3%. Fifteen risk factors were included, nine of which were significantly associated with an increased risk of AKI in critically ill neonates: gestational age [standardized mean difference (SMD) = −0.31, 95%CI = (−0.51, −0.12), P = 0.002], birthweight [SMD = −0.37, 95%CI = (−0.67, −0.07), P = 0.015], 1-min Apgar score [SMD = −0.61, 95%CI = (−0.78, −0.43), P = 0.000], 5-min Apgar score [SMD = −0.71, 95%CI = (−1.00, −0.41), P = 0.000], congenital heart disease (CHD) [odds ratio (OR) = 2.94, 95%CI = (2.08, 4.15), P = 0.000], hyperbilirubinemia [OR = 2.26, 95%CI = (1.40, 3.65), P = 0.001], necrotizing enterocolitis (NEC) [OR = 6.32, 95%CI = (2.98, 13.42), P = 0.000], sepsis [OR = 2.21, 95%CI = (1.25, 3.89), P = 0.006], and mechanical ventilation [OR = 2.37, 95%CI = (1.50, 3.75), P = 0.000]. Six of them were not significantly associated with AKI in critically ill neonates: age [SMD = −0.25, 95%CI = (−0.54, 0.04), P = 0.095], male sex [OR = 1.10, 95%CI =(0.97, 1.24), P = 0.147], prematurity [OR = 0.90, 95%CI(0.52, 1.56), P = 0.716], cesarean section [OR = 1.52, 95%CI(0.77, 3.01), P = 0.234], prenatal hemorrhage [OR = 1.41, 95%CI = (0.86, 2.33), P = 0.171], and vancomycin [OR = 1.16, 95%CI = (0.71, 1.89), P = 0.555].Conclusions: This meta-analysis provides a preliminary exploration of risk factors in critically ill neonatal AKI, which may be useful for the prediction of AKI.Systematic Review Registration: PROSPERO (CRD42020188032).

scholarly journals Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Haixia Wang ◽  
Mo Yi ◽  
Yuanmin Jia ◽  
Chenxiao Bai ◽  
Di Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Tube Placement ◽  
Cochrane Library ◽  
Abdominal Pressure ◽  
Ventilator Associated Pneumonia ◽  
Increased Risk

Abstract BackgroundVentilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However，the incidence rates, risk factors and mortality rates of VAP are controversial.MethodsThe Web of Science, PubMed and Cochrane Library databases through August 2019 were independently searched by two researchers to collect all relevant studies. Data including morbidity, risk factors and mortality rates of VAP were extracted for the systematic review and meta-analysis.ResultsSixteen studies, including 4 case control studies and 12 cohort studies, on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 22/1000 ventilator-days (95% CI 18–25%). The data demonstrated that H 2 blocker use (odds ratio (OR) 1.66; 95% CI 1.17-2.36), nasogastric tube placement (OR 2.88; 95% CI 1.03-8.04), enteral feeding (OR 3.02; 95% CI 2.18-4.20), central vascular catheter (CVC) placement (OR 3.84; 95% CI 2.55-5.78) and tracheotomy (OR 9.13; 95% CI 6.53-12.75) were risk factors of VAP. VAP was associated with an increased risk of mortality (OR 1.15; 95% CI 0.96-1.37). Four articles that were not included in the meta-analysis indicated that hyperoxemia, increased intra-abdominal pressure, and genetic polymorphism may be risk factors for VAP. ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.

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