scholarly journals Does liver cirrhosis affect the surgical outcome of primary colorectal cancer surgery? A meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu-Xi Cheng ◽  
Wei Tao ◽  
Hua Zhang ◽  
Dong Peng ◽  
Zheng-Qiang Wei
Keyword(s):  
Colorectal Cancer ◽  
Liver Cirrhosis ◽  
Mortality Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Poor Overall Survival ◽  
Operation Rate ◽  
Short Term Mortality ◽  
Cirrhotic Group

Abstract Purpose The purpose of this meta-analysis was to evaluate the effect of liver cirrhosis (LC) on the short-term and long-term surgical outcomes of colorectal cancer (CRC). Methods The PubMed, Embase, and Cochrane Library databases were searched from inception to March 23, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of enrolled studies, and RevMan 5.3 was used for data analysis in this meta-analysis. The registration ID of this current meta-analysis on PROSPERO is CRD42021238042. Results In total, five studies with 2485 patients were included in this meta-analysis. For the baseline information, no significant differences in age, sex, tumor location, or tumor T staging were noted. Regarding short-term outcomes, the cirrhotic group had more major complications (OR=5.15, 95% CI=1.62 to 16.37, p=0.005), a higher re-operation rate (OR=2.04, 95% CI=1.07 to 3.88, p=0.03), and a higher short-term mortality rate (OR=2.85, 95% CI=1.93 to 4.20, p<0.00001) than the non-cirrhotic group. However, no significant differences in minor complications (OR=1.54, 95% CI=0.78 to 3.02, p=0.21) or the rate of intensive care unit (ICU) admission (OR=0.76, 95% CI=0.10 to 5.99, p=0.80) were noted between the two groups. Moreover, the non-cirrhotic group exhibited a longer survival time than the cirrhotic group (HR=2.96, 95% CI=2.28 to 3.85, p<0.00001). Conclusion Preexisting LC was associated with an increased postoperative major complication rate, a higher rate of re-operation, a higher short-term mortality rate, and poor overall survival following CRC surgery.

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 Relation between Volume and Outcome of Transcatheter and Surgical Aortic Valve Replacement: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jialing He ◽  
Zhen Zhang ◽  
Han Wang ◽  
Lin Cai
Keyword(s):  
Systematic Review ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Meta Analysis ◽  
High Volume ◽  
Cochrane Library ◽  
Short Term ◽  
Surgical Aortic Valve Replacement ◽  
Short Term Mortality

Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are standard procedures for dealing with severe aortic stenosis patients. Researchers have not carried out a systematic review of the volume-outcome relationship in TAVR and SAVR. Our study is intended to address this problem. We systemically searched databases through MEDLINE, EMBASE, PUBMED, and the Cochrane Library up to September 2019. Two reviewers independently screened for the studies and evaluated bias. We used short-term mortality (in-hospital or 30-day mortality) as an outcome. A meta-analysis of TAVR with 115,596 patients ranging from 2005 to 2016 showed a result significantly in favor of high-volume hospitals (OR 0.43 (CI 0.36-0.51)). The subgroup of population period, region, data type, and cut-off value did not show any difference. A meta-analysis of SAVR comprising 418,384 patients ranging from 1994 to 2011 revealed that the OR of short-term mortality for a high-volume hospital compared with that of a low-volume hospital was 0.73 (CI 0.71, 0.74). No difference was observed in subgroups based on population period and cut-off. In conclusion, we found that short-term mortality was lower in high-volume hospitals for both TAVR and SAVR.

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 Steroid, ascorbic acid, and thiamine in adults with sepsis and septic shock: a systematic review and component network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ka Man Fong ◽  
Shek Yin Au ◽  
George Wing Yiu Ng
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Ascorbic Acid ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Short Term ◽  
Short Term Mortality ◽  
Sepsis And Septic Shock

AbstractTo assess the effect from individual component in combinations of steroid, ascorbic acid, and thiamine on outcomes in adults with sepsis and septic shock with component network meta-analysis (NMA). We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials from 1980 to March 2021 for randomized controlled trials (RCT) that studied the use of glucocorticoid, fludrocortisone, ascorbic acid, and thiamine in patients with sepsis and septic shock. Citations screening, study selection, data extraction, and risk of bias assessment were independently performed by two authors. The primary outcome was short-term mortality. Secondary outcomes were longer-term mortality, time to resolution of shock and duration of mechanical ventilation. Thirty-three RCTs including 9898 patients presented on short-term mortality. In additive component NMA, patients on ascorbic acid alone (RR 0.74, 95% CI 0.57–0.97) or the combination of glucocorticoid and fludrocortisone (RR 0.89, 95% CI 0.80–0.99) had lower short-term mortality, but only the latter was associated with improved long-term mortality (RR 0.89, 95% CI 0.82–0.98). The use of glucocorticoid or the combination of glucocorticoid, ascorbic acid and thiamine hastened resolution of shock. Component NMA showed glucocorticoid (MD − 0.96, 95% CI − 1.61 to − 0.30) but not ascorbic acid or thiamine shortened the time to resolution of shock. Glucocorticoid shortened the duration of mechanical ventilation (MD − 1.48, 95% CI − 2.43 to − 0.52). In adults with sepsis and septic shock, the combination of glucocorticoid and fludrocortisone improved short-term and longer-term mortality. Glucocorticoid shortened the time to resolution of shock and duration of mechanical ventilation. There was no strong evidence supporting the routine use of thiamine and ascorbic acid, but they were associated with minimal adverse effects.

S-1 and Capecitabine for the Treatment of Colorectal Cancer: A Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 1144-1152
Author(s):  
Ping Huang ◽  
Zhenfen Wang ◽  
Qian Liu ◽  
Guohao Cai
Keyword(s):  
Colorectal Cancer ◽  
Web Of Science ◽  
Advanced Colorectal Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Chemotherapeutic Drugs ◽  
The Third ◽  
Hand Foot Syndrome ◽  
The Cochrane Library

Colorectal cancers common tumors that develop in the large intestines. The incidence of colorectal cancer is second only to gastric and esophageal cancers. Both S-1 and capecitabine are the third-generation fluorouracil-based chemotherapeutic drugs. We hope to summarize the therapeutic effects of tecotae and capecitabine in patients with colorectal cancer through this Meta-analysis. We performed a meta-analysis of the findings in the current literature. We performed a systematic review of outcomes associated with S-1 and capecitabine used to treat advanced colorectal cancer based on findings from both English and Chinese publications listed in PubMed, Embase, CNKI, Wanfang, EBSCO, Web of Science and the Cochrane Library. End-points included ORR, DCR, OS, and PFS; adverse events (grades 1–2 and 3–4) were also evaluated. Statistical analysis was performed using RevMan 5.3. A total of 12 studies were eventually included, involving a total of 3,375 patients. Of this group, 1,683 and 1,692 patients underwent treatment with S-1 or capecitabine, respectively. There were no greatly differences with respect to ORR, DCR, or OS; however, PFS was bettered in the group of S-1 compared to those treated with capecitabine. The incidence of leukopenia, diarrhea and anorexia were all higher among those in S-1 group compared to the capecitabine group, but a higher incidence of hand-foot syndrome was linked with use of capecitabine. Use of S-1 for the treatment of colorectal cancer may result in superior outcomes when compared to use of capecitabine.

scholarly journals A model predicting short-term mortality in patients with advanced liver cirrhosis and concomitant infection

Medicine ◽  
2018 ◽  
Vol 97 (41) ◽  
pp. e12758 ◽  
Author(s):  
Ying Li ◽  
Roongruedee Chaiteerakij ◽  
Jung Hyun Kwon ◽  
Jeong Won Jang ◽  
Hae Lim Lee ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Short Term ◽  
Concomitant Infection ◽  
Advanced Liver Cirrhosis ◽  
Short Term Mortality

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

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.

scholarly journals The course and survival of patients with liver cirrhosis and acute liver failure on the background of chronic

2020 ◽  
Vol 98 (2) ◽  
pp. 137-141
Author(s):  
S. A. Avezov ◽  
S. M. Azimova ◽  
M. H. Abdulloev
Keyword(s):  
Liver Cirrhosis ◽  
Mortality Rate ◽  
Liver Failure ◽  
Organ Failure ◽  
Predictive Factors ◽  
Clinical Signs ◽  
Multiple Organ ◽  
Kaplan Meier ◽  
Short Term Mortality ◽  
Acute Decompensation

Aims. We comparative investigated the frequency, precipitating factors, lifetimes and predictive factors of survival in patients with liver cirrhosis (LC) and acute-on-chronic liver failure (ACLF). Material and methods. We collected data from 310 hospitalized patients with LC. Patients divided into groups: 1 — patients with compensation of LC; 2 — patients with decompensation of LC, but without organ failure (OF) and 3 — patients with ACLF. Diagnostic criteria for ACLF based on consensus recommendations of EASL. Survival was assessed according to the Kaplan-Meier method. Results. 48 patients with LC reported clinical signs of ACLF. 28-day mortality was in 4,8% of patients without ACLF and in 42,0% of patients with ACLF. 90-day mortality of patients with ACLF was 50% versus 11.6% in patients without ACLF. 6-month survival rate of patients with the development of acute decompensation with organ failure was only 33,3%. The lifetimes of patients with ACLF was only 136,65 ± 18,96 days. The predictive factors of survival of patients with LC and ACLF are: the number of organ failure, indicators of CLIF-SOFA and MELD, Child-Pugh score, degree of hepatic encephalopathy, leukocytosis, hyperbilirubinemia, hypercreatininemia and increased INR. Conclusion. The prevalence of ACLF in patients with LC is 15,5% and develops against a background of stable compensated or decompensated CP. The frequent trigger of ACLF is infection, which causes acute decompensation with the development of multiple organ failure and a high incidence of short-term mortality. The 28-day mortality rate in patients with ACLF was 8.7 times greater than the mortality rate in patients with decompensated LC without ACLF.

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