Risk factors for postoperative cerebellar mutism syndrome in pediatric patients: a systematic review and meta-analysis

2021 ◽  
pp. 1-9
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pediatric Patients ◽  
Intraoperative Imaging ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Cerebellar Hemisphere ◽  
Superior Cerebellar Peduncle ◽  
Cerebellar Mutism

OBJECTIVE A review article assessing all the risk factors reported in the literature for postoperative cerebellar mutism syndrome (pCMS) among children remains absent. The authors sought to perform a systematic review and meta-analysis to evaluate this issue. METHODS PubMed, Embase, and Web of Science were queried to systematically extract potential references. The articles relating to pCMS were required to be written in the English language, involve pediatric patients (≤ 18 years of age), and provide extractable data, which included a comparison group of patients who did not develop pCMS. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Data were pooled using RevMan 5.4, and publication bias was assessed by visual inspection for funnel plot asymmetry. The study protocol was registered through PROSPERO (ID: CRD42021256177). RESULTS Overall, 28 studies involving 2276 patients were included. Statistically significant risk factors identified from univariate analysis were brainstem invasion (OR 4.28, 95% CI 2.23–8.23; p < 0.0001), fourth ventricle invasion (OR 12.84, 95% CI 4.29–38.44; p < 0.00001), superior cerebellar peduncle invasion (OR 6.77, 95% CI 2.35–19.48; p = 0.0004), diagnosis of medulloblastoma (OR 3.26, 95% CI 1.93–5.52; p < 0.0001), medulloblastoma > 50 mm (OR 8.85, 95% CI 1.30–60.16; p = 0.03), left-handedness (OR 6.57, 95% CI 1.25–34.44; p = 0.03), and a vermis incision (OR 5.44, 95% CI 2.09–14.16; p = 0.0005). On the other hand, a tumor located in the cerebellar hemisphere (OR 0.23, 95% CI 0.06–0.92; p = 0.04), cerebellar hemisphere compression (OR 0.23, 95% CI 0.11–0.45; p < 0.0001), and intraoperative imaging (OR 0.36, 95% CI 0.18–0.72; p = 0.004) reduced the risk of pCMS. CONCLUSIONS This study provides the largest and most reliable review of risk factors associated with pCMS. Although some risk factors may be dependent on one another, the data may be used by surgeons to better identify patients at risk for pCMS and for intervention planning.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport

2020 ◽  
Vol 54 (18) ◽  
pp. 1081-1088 ◽  
Author(s):  
Brady Green ◽  
Matthew N Bourne ◽  
Nicol van Dyk ◽  
Tania Pizzari
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Significant Risk ◽  
Older Age ◽  
Future Research ◽  
Hamstring Strain ◽  
Best Evidence Synthesis ◽  
History Of

ObjectiveTo systematically review risk factors for hamstring strain injury (HSI).DesignSystematic review update.Data sourcesDatabase searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.Eligibility criteria for selecting studiesStudies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.MethodSearch result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.ResultsThe 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.Summary/conclusionOlder age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.

scholarly journals Dialysis patients have comparable results to patients who have received kidney transplant after total joint arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 6 (8) ◽  
pp. 618-628
Author(s):  
Te-Feng Arthur Chou ◽  
Hsuan-Hsiao Ma ◽  
Shang-Wen Tsai ◽  
Cheng-Fong Chen ◽  
Po-Kuei Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Kidney Transplant ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
Significant Risk ◽  
Joint Arthroplasty ◽  
Dialysis Patients ◽  
Cochrane Reviews

Patients with end-stage renal disease (ESRD) have inferior outcomes after hip and knee total joint arthroplasty (TJA), with higher risk for surgical site complications (SSC) and periprosthetic joint infection (PJI). We conducted a systematic review and meta-analysis regarding outcomes after hip and knee TJA in ESRD patients who have received dialysis or a kidney transplant (KT) using PubMed, MEDLINE, Cochrane Reviews, and Embase in order to: (1) determine the mortality and infection rate of TJA in patients receiving dialysis or KT and (2) to identify risk factors associated with the outcome. We included 22 studies and 9384 patients (dialysis, n = 8921, KT, n = 463). The overall mortality rate was 14.9% and was slightly higher in KT patients (dialysis vs. KT, 13.8% vs. 15.8%). The overall SSC rate was 3.4%, while dialysis and KT patients each had an incidence of 3.3% and 3.6%, respectively. For PJI, the overall rate was 3.9%, while the incidence for dialysis patients was 4.0% and for KT patients was 3.7%. Using multi-regression analysis, age, sex, the type of arthroplasty (knee or hip) performed, and the form of renal replacement therapy (dialysis or KT) were not significant risk factors. In patients on dialysis or who had received a KT, TJA is associated with a slight increase in mortality, SSC and PJI rates. Cite this article: EFORT Open Rev 2021;6:618-628. DOI: 10.1302/2058-5241.6.200116

scholarly journals Risk factors for infectiousness of patients with tuberculosis: a systematic review and meta-analysis

2018 ◽  
Vol 146 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Y.A. Melsew ◽  
T.N. Doan ◽  
M. Gambhir ◽  
A.C. Cheng ◽  
E. McBryde ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Significant Risk ◽  
Sputum Smear ◽  
Targeted Interventions ◽  
Related Risk ◽  
Cavitary Disease ◽  
Meta Analyses

AbstractWe performed a systematic review and meta-analyses of studies assessing tuberculosis (TB) patient-related risk factors for transmission of Mycobacterium tuberculosis infection. Meta-analyses were conducted for sputum smear-positivity, lung cavitation and HIV seropositivity of index patients with both crude and adjusted odds ratios (AORs) pooled using random effect models. Thirty-seven studies were included in the review. We found that demographic characteristics such as age and sex were not significant risk factors, while behaviours such as smoking and alcohol intake were associated with infectiousness although inconsistently. Treatment delay of >28 days was a significant predictor of greater infectiousness. Contacts of sputum smear-positive index patients were found to be more likely to be infected than contacts of sputum smear-negative patients, with a pooled AOR of 2.15 (95% confidence interval (CI) 1.47–3.17, I2 = 38%). Similarly, contacts of patients with the cavitary disease were around twice as likely to be infected as contacts of patients without cavitation (pooled AOR 1.9, 95% CI 1.26–2.84, I2 = 63%). In contrast, HIV seropositive patients were associated with few contact infections than HIV seronegative patients (AOR 0.45, 95% CI 0.26–0.80, I2 = 52%). In conclusion, behavioural and clinical characteristics of TB patients can be used to identify highly infectious patients for targeted interventions.

scholarly journals Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

2021 ◽  
pp. 026921632110652
Author(s):  
Imogen Featherstone ◽  
Trevor Sheldon ◽  
Miriam Johnson ◽  
Rebecca Woodhouse ◽  
Jason W Boland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Palliative Care ◽  
Meta Analysis ◽  
Performance Status ◽  
Univariate Analysis ◽  
Adult Patients ◽  
Modifiable Risk Factors ◽  
Specialist Palliative Care ◽  
Context Specific

Background: Delirium is common and distressing for patients receiving palliative care. Interventions targetting modifiable risk factors in other settings have been shown to prevent delirium. Research on delirium risk factors in palliative care can inform context-specific risk-reduction interventions. Aim: To investigate risk factors for the development of delirium in adult patients receiving specialist palliative care. Design: Systematic review and meta-analysis (PROSPERO CRD42019157168). Data sources: CINAHL, Cochrane Database of Systematic Reviews, Embase, MEDLINE and PsycINFO (1980-2021) were searched for studies reporting the association of risk factors with delirium incidence/prevalence for patients receiving specialist palliative care. Study risk of bias and certainty of evidence for each risk factor were assessed. Results: Of 28 included studies, 16 conducted only univariate analysis, 12 conducted multivariate analysis. The evidence for delirium risk factors was limited with low to very low certainty. Potentially modifiable risk factors: Opioids and lower performance status were positively associated with delirium, with some evidence also for dehydration, hypoxaemia, sleep disturbance, liver dysfunction and infection. Mixed, or very limited, evidence was found for some factors targetted in multicomponent prevention interventions: sensory impairments, mobility, catheter use, polypharmacy (single study), pain, constipation, nutrition (mixed evidence). Non-modifiable risk factors: Older age, male sex, primary brain cancer or brain metastases and lung cancer were positively associated with delirium. Conclusions: Findings may usefully inform interventions to reduce delirium risk but more high quality prospective cohort studies are required to enable greater certainty about associations of different risk factors with delirium during specialist palliative care.

scholarly journals Risk factors for Clostridium difficile infection in pediatric inpatients: A meta-analysis and systematic review

2019 ◽  
Vol 40 (4) ◽  
pp. 420-426 ◽  
Author(s):  
Scott Anjewierden ◽  
Zheyi Han ◽  
Charles B. Foster ◽  
Chaitanya Pant ◽  
Abhishek Deshpande
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Meta Analysis ◽  
Significant Risk ◽  
Female Gender ◽  
Significant Risk Factor ◽  
Antibiotic Exposure ◽  
H2 Receptor Antagonist ◽  
Increased Risk

AbstractObjective:To summarize risk factors for Clostridioides (formerly Clostridium) difficile infection (CDI) in hospitalized pediatric patients as determined by previous observational studies.Design:Meta-analysis and systematic review.Patients:Studies evaluating risk factors for CDI in pediatric inpatients were eligible for inclusion.Method:We systematically searched MEDLINE, Web of Science, Scopus, and EMBASE for subject headings and text words related to CDI and pediatrics from 1975 to 2017. Two of the investigators independently screened studies, extracted and compiled data, assessed study quality, and performed the meta-analysis.Results:Of the 2,033 articles screened, 14 studies reporting 10,531,669 children met the inclusion criteria. Prior antibiotic exposure (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31–3.52) and proton pump inhibitor (PPI) use (OR, 1.33; 95% CI, 1.07–1.64) were associated with an increased risk of CDI in children. Subgroup analyses using studies reporting only adjusted results suggested that prior antibiotic exposure is not a significant risk factor for CDI. H2 receptor antagonist (H2RA) use (OR, 1.36; 95% CI, 0.31–5.98) and that female gender (OR, 0.87; 95% CI, 0.74–1.03) did not play a significant role as a risk factor for developing CDI.Conclusion:Prior antibiotic exposure appears to be an important risk factor for CDI based on the combined analysis but not significant using adjusted studies. PPI use was associated with an increased risk of CDI. Judicious and appropriate use of antibiotics and PPIs may help reduce the risk of CDI in this vulnerable population.

Cerebellar mutism

2013 ◽  
Vol 12 (6) ◽  
pp. 604-614 ◽  
Author(s):  
Marina Pitsika ◽  
Vassilios Tsitouras
Keyword(s):  
Risk Factors ◽  
English Language ◽  
Tumor Resection ◽  
Treatment Strategies ◽  
Significant Risk ◽  
Cerebellar Hemisphere ◽  
Minimal Risk ◽  
Cerebellar Mutism ◽  
Effective Prevention ◽  
Pubmed Database

Mutism of cerebellar origin is a well-described clinical entity that complicates operations for posterior fossa tumors, especially in children. This review focuses on the current understanding of principal pathophysiological aspects and risk factors, epidemiology, clinical characteristics, treatment strategies, and outcome considerations. The PubMed database was searched using the term cerebellar mutism and relevant definitions to identify publications in the English-language literature. Pertinent publications were selected from the reference lists of the previously identified articles. Over the last few years an increasing number of prospective studies and reviews have provided valuable information regarding the cerebellar mutism syndrome. Importantly, the clarification of principal terminology that surrounds the wide clinical spectrum of the syndrome results in more focused research and more effective identification of this entity. In children who undergo surgery for medulloblastoma the incidence of cerebellar mutism syndrome was reported to be 24%, and significant risk factors so far are brainstem involvement and midline location of the tumor. The dentate-thalamo-cortical tracts and lesions that affect their integrity are considered significant pathophysiological issues, especially the tract that originates in the right cerebellar hemisphere. Moderate and severe forms of the cerebellar mutism syndrome are the most frequent types during the initial presentation, and the overall neurocognitive outcome is not as favorable as thought in the earlier publications. Advanced neuroimaging techniques could contribute to identification of high-risk patients preoperatively and allow for more effective surgical planning that should focus on maximal tumor resection with minimal risk to important neural structures. Properly designed multicenter trials are needed to provide stronger evidence regarding effective prevention of cerebellar mutism and the best therapeutic approaches for such patients with a combination of pharmacological agents and multidisciplinary speech and behavior augmentation.

scholarly journals Predicting relapse in ANCA-associated vasculitis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Catherine King ◽  
Katie L Druce ◽  
Peter Nightingale ◽  
Ellen Kay ◽  
Neil Basu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Significant Risk ◽  
Term Treatment ◽  
Individual Risk ◽  
Relapse Risk ◽  
Anca Associated Vasculitis ◽  
Increased Risk ◽  
Long Term Treatment

Abstract Objectives Relapses affect 30-50% of patients with anti-neutrophil cytoplasm antibody (ANCA) associated vasculitis (AAV) over 5 years, necessitating long term treatment. Whilst there have been studies looking at predictors of relapse in AAV, this research has yet to translate clinically into guidance on tailored therapy. The aim of this systematic review was to identify and meta-analyse existing risk factors from the literature and produce a model to calculate individualised patient relapse risk. Method A search strategy was developed to include all studies identifying predictors of AAV relapse using multivariate analysis. Individual risk factors were extracted, and pooled hazard ratios (HRs) calculated. A model to predict time to first relapse based on identified risk factors was retrospectively tested using a cohort of patients with AAV. Results The review of 2,674 abstracts identified 117 papers for full text review, with 16 eligible for inclusion. Pooled HRs were calculated from significant risk factors including PR3 ANCA positivity HR 1.69 (1.46-1.94), cardiovascular involvement HR 1.78 (1.26-2.53), creatinine &gt;200µmol/l (relative to creatinine ≤100) HR 0.39 (0.22-0.69) and creatinine 101-200µmol/l HR 0.81 (0.77-0.85). Using data from 182 AAV patients to validate the model gave a C-statistic of 0.61. Conclusion PR3 ANCA positivity, lower serum creatinine and cardiovascular system involvement are all associated with an increased risk of relapse and a combination of these risk factors can be used to predict an individual’s relapse risk. In order to produce a clinically useful model to stratify risk, we need to identify more risk factors with a focus towards robust biomarkers.

scholarly journals Estimating the burden of hypertension and its significant risk factors among male commercial drivers in sub-Saharan Africa: A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053825
Author(s):  
Martin Ackah ◽  
Louise Ameyaw ◽  
Mohammed Gazali Salifu ◽  
Cynthia Osei Yeboah
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Risk ◽  
Sub Saharan Africa ◽  
Male Adult ◽  
Commercial Drivers ◽  
Sub Saharan

ObjectiveThe study was designed to assess the burden and significant risk factors among male commercial drivers in sub-Saharan Africa (SSA).DesignSystematic review and meta-analysis.Data sourcesMedline via PubMed, Google Scholar, Cochrane databases and Africa Journal Online were searched from January 2010 to December 2020.Eligibility criteria for selecting studiesThe authors included observational studies reporting on the burden and/or risk factors for hypertension among commercial drivers in SSA. Male adult population ≥18 years working as a commercial driver in SSA as well articles published in English.Data extraction and synthesisTwo independent coauthors used a prepared data extraction form to extract data from the eligible published papers and assessed the risk of bias. DerSimonian and Laird random effects model was used to pool the burden of hypertension and significant risk factors among male commercial drivers in SSA. The presence of heterogeneity among studies was quantified by estimating variance using both Cochrane’s Q statistics and the I2 statistics. A subgroup and sensitivity analyses were performed.ResultsOverall, 14 articles met the inclusion criteria involving a total of 4285 male commercial drivers in SSA. The estimated pooled burden of hypertension among the male commercial drivers in SSA was 32% (95% CI 24% to 39%). The risk factors identified were age OR=1.10 (95% CI 1.06 to 1.15), overweight/obese OR=3.38 (95% CI 2.46 to 4.29), alcohol consumption OR=3.00 (95% CI 2.05 to 3.95) and duration of driving (≥5 years) OR=1.83 (95% CI 1.03 to 2.63). Funnel plot inspection and Egger’s regression test of small effect (0.5838) showed no evidence of publication bias.ConclusionsOur review showed that nearly one-third of male commercial drivers in SSA have hypertension. Reduction of modifiable risk factors such as overweight/obesity, alcohol consumption and long-term driving through multifaceted implementation strategies are recommended for prevention and control of hypertension among male commercial drivers in SSA.Trial registration numberCRD42021250910.

scholarly journals The prevalence of and risk factors for dysphagia among elderly residents in nursing homes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Zhao Hu ◽  
Baohua Zheng ◽  
Atipatsa Chiwanda Kaminga ◽  
Huilan Xu
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Nursing Homes ◽  
English Language ◽  
Meta Analysis ◽  
Functional Limitation ◽  
Significant Risk ◽  
Assessment Tools ◽  
Significant Difference ◽  
Prevalence Estimates

Abstract Background Elderly residents in nursing homes are at high risk for dysphagia. However, the prevalence estimates of this condition and its risk factors among this population were inconsistent. Objective To estimate the prevalence of dysphagia and examine its risk factors among the elderly in nursing homes. Methods Electronic database of PubMed, Web of science, Embase for English language, Wangfang, VIP and CNKI for Chinese language were systematically searched to identify relevant observational studies published not later than July 4, 2021. Studies conducted in nursing homes and reported dysphagia assessment methods were included. Results In total, 43 studies involving 56,746 participants were included in this systematic review and meta-Analysis. The overall pooled crude prevalence of dysphagia was 35.9% (95%CI: 29.0%, 43.4%), with high heterogeneity (I2 = 99.5%). There was a statistically significant difference in prevalence estimates with respect to study locations, methods of assessment of dysphagia, dysphagia assessment staff, representativeness of samples, and validity of assessment tools. Pooled estimates indicated that male (OR = 1.13, 95%CI: 1.00, 1.27), cognitive impairment (OR = 2.47, 95%CI: 1.59, 3.84), functional limitation (OR = 2.59, 95% CI: 1.75, 3.84), cerebrovascular disease (OR = 2.90, 95%CI: 1.73,4.87), dementia (OR = 1.50, 95%CI: 1.15, 1.96) and Parkinson’s disease (OR = 1.81, 95%CI: 1.06, 3.08) were significant risk factors for dysphagia. Conclusions The prevalence of dysphagia in nursing homes is relatively high, and with high heterogeneity. Also, many factors were associated with the risk of dysphagia. Further research is needed to identify strategies for management and interventions targeted at these disorders in this population.

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