Tight glycaemic control and surgical site infections post cardiac surgery: a systematic review

2021 ◽  
Vol 30 (Sup12) ◽  
pp. S22-S28
Author(s):  
Issa M Hweidi ◽  
Ala M Zytoo ◽  
Audai A Hayajneh
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Glycaemic Control ◽  
Health Outcomes ◽  
Tight Glycaemic Control ◽  
Control Protocol ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Patients With Diabetes ◽  
Post Cardiac Surgery

Objective: Surgical site infection (SSI) is one of the most serious potential complications post cardiac surgery among patients with diabetes and has a number of adverse health outcomes. The literature shows discrepancies regarding the effect of different glycaemic control protocols on reducing adverse health outcomes including SSIs. The aim of this study was to conduct a systematic review that investigated the effect of the optimal range of tight glycaemic control protocols using a continuous insulin infusion on reducing the incidence of SSIs in adult patients with diabetes undergoing cardiac surgery. Method: A systematic review was conducted following the PRISMA statement and guidelines. Search terms were used to identify research studies published between 2000 and 2019 across five key databases, including CINAHL, Medline, PubMed, Cochrane Database and Google Scholar. Results: A total of 12 studies met the review inclusion criteria. The reviewed literature tended to support the implementation of a tight glycaemic control protocol, particularly in the postoperative phase, that demonstrated fewer potential complications associated with cardiac surgery. On the other hand, the literature also supported the application of a moderate glycaemic control protocol in the intraoperative phase to obtain better glycaemic stability with fewer potential complications among those patients with diabetes undergoing cardiac surgery. Conclusion: This analysis concludes that tight glycaemic control is more effective than moderate glycaemic control intraoperatively in terms of glycaemic stability among patients with diabetes undergoing cardiac surgery. Results also emphasised the importance of time-based protocol implementation to ensure better health outcomes and better quality of care for patients.

scholarly journals Understanding the influence of socioeconomic status on the association between combinations of lifestyle factors and adverse health outcomes: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042212
Author(s):  
Hamish Foster ◽  
Peter Polz ◽  
Frances Mair ◽  
Jason Gill ◽  
Catherine A O'Donnell
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Lifestyle Factors ◽  
Lifestyle Factor ◽  
Unhealthy Lifestyle ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
The Impact

IntroductionCombinations of unhealthy lifestyle factors are strongly associated with mortality, cardiovascular disease (CVD) and cancer. It is unclear how socioeconomic status (SES) affects those associations. Lower SES groups may be disproportionately vulnerable to the effects of unhealthy lifestyle factors compared with higher SES groups via interactions with other factors associated with low SES (eg, stress) or via accelerated biological ageing. This systematic review aims to synthesise studies that examine how SES moderates the association between lifestyle factor combinations and adverse health outcomes. Greater understanding of how lifestyle risk varies across socioeconomic spectra could reduce adverse health by (1) identifying novel high-risk groups or targets for future interventions and (2) informing research, policy and interventions that aim to support healthy lifestyles in socioeconomically deprived communities.Methods and analysisThree databases will be searched (PubMed, EMBASE, CINAHL) from inception to March 2020. Reference lists, citations and grey literature will also be searched. Inclusion criteria are: (1) prospective cohort studies; (2) investigations of two key exposures: (a) lifestyle factor combinations of at least three lifestyle factors (eg, smoking, physical activity and diet) and (b) SES (eg, income, education or poverty index); (3) an assessment of the impact of SES on the association between combinations of unhealthy lifestyle factors and health outcomes; (4) at least one outcome from—mortality (all cause, CVD and cancer), CVD or cancer incidence. Two independent reviewers will screen titles, abstracts and full texts of included studies. Data extraction will focus on cohort characteristics, exposures, direction and magnitude of SES effects, methods and quality (via Newcastle-Ottawa Scale). If appropriate, a meta-analysis, pooling the effects of SES, will be performed. Alternatively, a synthesis without meta-analysis will be conducted.Ethics and disseminationEthical approval is not required. Results will be disseminated via peer-reviewed publication, professional networks, social media and conference presentations.PROSPERO registration numberCRD42020172588.

scholarly journals Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Candyce Hamel ◽  
Adrienne Stevens ◽  
Kavita Singh ◽  
Mohammed T Ansari ◽  
Esther Myers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Systematic Review Protocol ◽  
Sugar Sweetened Beverages ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Sweetened Beverages ◽  
Review Protocol

scholarly journals Prevalence of polypharmacy and associated adverse health outcomes in adult patients with chronic kidney disease: protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ikechi G. Okpechi ◽  
Mohammed M. Tinwala ◽  
Shezel Muneer ◽  
Deenaz Zaidi ◽  
Feng Ye ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Adult Patients ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Inappropriate Medications

Abstract Background Polypharmacy, often defined as the concomitant use of ≥ 5 medications, has been identified as a significant global public health threat. Aging and multimorbidity are key drivers of polypharmacy and have been linked to a broad range of adverse health outcomes and mortality. Patients with chronic kidney disease (CKD) are particularly at high risk of polypharmacy and use of potentially inappropriate medications given the numerous risk factors and complications associated with CKD. The aim of this systematic review will be to assess the prevalence of polypharmacy among adult patients with CKD, and the potential association between polypharmacy and adverse health outcomes within this population. Methods/design We will search empirical databases such as MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and PsycINFO and grey literature from inception onwards (with no language restrictions) for observational studies (e.g., cross-sectional or cohort studies) reporting the prevalence of polypharmacy in adult patients with CKD (all stages including dialysis). Two reviewers will independently screen all citations, full-text articles, and extract data. Potential conflicts will be resolved through discussion. The study methodological quality will be appraised using an appropriate tool. The primary outcome will be the prevalence of polypharmacy. Secondary outcomes will include any adverse health outcomes (e.g., worsening kidney function) in association with polypharmacy. If appropriate, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence of polypharmacy and the associations between polypharmacy and adverse outcomes. Statistical heterogeneity will be estimated using Cochran’s Q and I2 index. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., sex, kidney replacement therapy, multimorbidity). Discussion Given that polypharmacy is a major and a growing public health issue, our findings will highlight the prevalence of polypharmacy, hazards associated with it, and medication thresholds associated with adverse outcomes in patients with CKD. Our study will also draw attention to the prognostic importance of improving medication practices as a key priority area to help minimize the use of inappropriate medications in patients with CKD. Systematic review registration PROSPERO registration number: [CRD42020206514].

Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological studies

2020 ◽  
Vol 20 (1) ◽  
pp. 133-143 ◽  
Author(s):  
Gill Schierhout ◽  
Skye McGregor ◽  
Antoine Gessain ◽  
Lloyd Einsiedel ◽  
Marianne Martinello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Adverse Health ◽  
Adverse Health Outcomes
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