A Systematic Review and Meta-Analysis on the Use of Preemptive Hemodynamic Intervention to Improve Postoperative Outcomes in Moderate and High-Risk Surgical Patients

2011 ◽  
Vol 112 (6) ◽  
pp. 1392-1402 ◽  
Author(s):  
Mark A. Hamilton ◽  
Maurizio Cecconi ◽  
Andrew Rhodes
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Postoperative Outcomes ◽  
Surgical Patients

scholarly journals Incidence, risk factors, and outcomes of early postoperative hyperglycemia in surgical patients: a protocol for a systematic review and meta-analysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Paddy Ssentongo ◽  
Joseph A. Lewcun ◽  
Anna E. Ssentongo ◽  
David I. Soybel
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cohort Studies ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Geographical Location ◽  
Risk Of Bias ◽  
Postoperative Outcomes ◽  
Surgical Patients ◽  
Incidence Risk

Abstract Background Early postoperative hyperglycemia (POHG) is common and associated with poor postoperative outcomes. Currently, there is no systematic review and meta-analysis that addresses the knowledge gap of the incidence of POHG in surgical patients and that explores the associated risk factors and complications. The objective of this study will be to estimate the pooled incidence, risk factors, and clinical outcomes of early postoperative hyperglycemia in men and women globally. Methods We designed and registered a study protocol for a systematic review and meta-analysis of studies reporting the incidence of postoperative hyperglycemia (POHG). We will search PubMed (MEDLINE), Scopus, Web of Science, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), and Joana Briggs Institute EBF Database (from inception onwards). Randomized controlled trials and observational cohort studies reporting the incidence of POHG and conducted in surgical patients will be included. No age, geographical location, study design, or language limits will be applied. The primary outcome will be the incidence of POHG. Secondary outcomes will be risk factors and clinical outcomes of POHG. Two reviewers will independently screen citations, full text articles, and abstract data, extract data, and evaluate the quality and bias of included studies. Discrepancies will be resolved through discussion or consultation with a third researcher. The risk of bias and study methodological quality of included studies will be evaluated by the appropriate Cochrane risk of bias tool for randomized trials and Newcastle-Ottawa Scale for cohort studies. If feasible, we will conduct random effects meta-analysis with a logit transformation of proportions. We will report the probability of postoperative hyperglycemia as a measure of incidence rate, relative risk ratios (RR), and 95% confidence intervals to report the effects of the risk factors and postoperative outcomes. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., age, gender, geographical location, publication year, comorbidities, type of surgical procedure). The Egger test and funnel plots will be used to assess small study effects (publication bias). Discussion This systematic review and meta-analysis will identify, evaluate, and integrate the evidence on the incidence, risk factors, and outcomes of early POHG in surgical patients. The results of this study can be used to identify populations which may be at particular risk for POHG. Future studies which use this information to better guide post-operative glycemic control in surgical patients could be considered. Systematic review registration PROSPERO registration number CRD42020167138

scholarly journals Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aparna Saripella ◽  
Sara Wasef ◽  
Mahesh Nagappa ◽  
Sheila Riazi ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Geriatric Care ◽  
Surgical Patients ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Care Models ◽  
Comprehensive Geriatric Care

Abstract Background The elderly population is highly susceptible to develop post-operative complications after major surgeries. It is not clear whether the comprehensive geriatric care models are effective in reducing adverse events. The objective of this systematic review and meta-analysis is to determine whether the comprehensive geriatric care models improved clinical outcomes, particularly in decreasing the prevalence of delirium and length of hospital stay (LOS) in elderly surgical patients. Method We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and ICTRP between 2009 to January 23, 2020. We included studies on geriatric care models in elderly patients (≥60 years) undergoing elective, non-cardiac high-risk surgery. The outcomes were the prevalence of delirium, LOS, rates of 30-days readmission, and 30-days mortality. We used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds Ratio (OR) and Mean Difference (MD) using random effect model analysis. Results Eleven studies were included with 2672 patients [Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials (Non-RCTs): 7]. Data pooled from six studies showed that there was no significant difference in the prevalence of delirium between the intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI: 0.30–1.96; p = 0.57). Similarly, there were no significant differences in the LOS (MD: -0.55; 95% CI: − 2.28, 1.18; p = 0.53), 30-day readmission (12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67–1.77; p = 0.73), and 30-day mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66–2.69; p = 0.42). The quality of evidence was very low. Conclusions The geriatric care models involved pre-operative comprehensive geriatric assessment, and intervention tools to address cognition, frailty, and functional status. In non-cardiac high-risk surgeries, these care models did not show any significant difference in the prevalence of delirium, LOS, 30-days readmission rates, and 30-day mortality in geriatric patients. Further RCTs are warranted to evaluate these models on the postoperative outcomes. Trial registration PROSPERO registration number - CRD42020181779.

EUS-guided versus endoscopic transpapillary gallbladder drainage in high-risk surgical patients with acute cholecystitis: a systematic review and meta-analysis

2020 ◽  
Vol 34 (5) ◽  
pp. 1904-1913 ◽  
Author(s):  
Rajesh Krishnamoorthi ◽  
Mahendran Jayaraj ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Dhruv Singh ◽  
Joanna Law ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Acute Cholecystitis ◽  
Meta Analysis ◽  
Surgical Patients ◽  
Gallbladder Drainage

scholarly journals Incidence, risk factors and outcomes of early postoperative hyperglycemia in surgical patients: a protocol for a systematic review and meta-analysis

2020 ◽  
Author(s):  
Paddy Ssentongo ◽  
Joseph A. Lewcun ◽  
Anna E. Ssentongo ◽  
David I. Soybel
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cohort Studies ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Geographical Location ◽  
Risk Of Bias ◽  
Postoperative Outcomes ◽  
Surgical Patients ◽  
Incidence Risk

Abstract Background: Early postoperative hyperglycemia (POHG) is common and associated with poor postoperative outcomes. Currently, there is no systematic review and meta-analysis that addresses the knowledge gap of the incidence of POHG in surgical patients and that explores the associated risk factors and complications. The objective of this study will be to estimate the pooled incidence, risk factors and clinical outcomes of early postoperative hyperglycemia in men and women globally. Methods: We designed and registered a study protocol for a systematic review and meta-analysis of studies reporting the incidence of postoperative hyperglycemia (POHG). We will search PubMed (MEDLINE), Scopus, Web of Science, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), Joana Briggs Institute EBF Database (from inception onwards). Randomized controlled trials and observational cohort studies reporting the incidence of POHG and conducted in surgical patients will be included. No age, geographical location, study-design or language limits will be applied. The primary outcome will be the incidence of POHG. Secondary outcomes will be risk factors and clinical outcomes of POHG. Two reviewers will independently screen citations, full text articles, and abstract data, extract data, and evaluate the quality and bias of included studies. Discrepancies will be resolved through discussion or consultation with a third researcher. The risk of bias and study methodological quality of included studies will be evaluated by the appropriate Cochrane risk of bias tool for randomized trials and Newcastle-Ottawa Scale for cohort studies. If feasible, we will conduct random effects meta-analysis with a logit transformation of proportions. We will report the probability of postoperative hyperglycemia as a measure of incidence rate, relative risk ratios (RR) and 95% confidence intervals to report the effects of the risk factors and postoperative outcomes. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, gender, geographical location, publication year, comorbidities, type of surgical procedure). The Egger’s test and funnel plots will be used to assess small study effects (publication bias).Discussion This systematic review and meta-analysis will identify, evaluate and integrate the evidence on the incidence, risk factors and outcomes of early POHG in surgical patients. The results of this study can be used to identify populations which may be at particular risk for POHG. Future studies which use this information to better guide post-operative glycemic control in surgical patients could be considered.Systematic review registration: PROSPERO registration number CRD42020167138

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