scholarly journals Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Huoyan Liang ◽  
Heng Song ◽  
Ruiqing Zhai ◽  
Gaofei Song ◽  
Hongyi Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Evaluation Methodology ◽  
Cochrane Library ◽  
Assessment Development ◽  
Short Time ◽  
Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

scholarly journals Corticosteroids Had no Effect on 28-Days Mortality in Adult Patients with sepsis: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Huoyan Liang ◽  
Heng Song ◽  
Gaofei Song ◽  
Hongyi Li ◽  
Xianfei Ding ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Evaluation Methodology ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Assessment Development ◽  
Randomized Controlled ◽  
Long Term Mortality

Abstract Objective: Corticosteroids are a common option used in the treatment of sepsis. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. We performed this review to assess the efficacy and safety of corticosteroids in sepsis patients.Methods: We searched the PubMed, Embase, and Cochrane library databases from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on septic patients were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The data were pooled by using relative risk (RR) and mean difference (MD). The random-effects model were used to to eveluate the pooled MD or RR and 95% CI.Results: Fifty-three RCTs that included 12,310 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate), and long-term mortality (>60 d) (RR, 0.96; 95% CI, 0.88–1.05) in septic patients (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in ICU (RR, 0.89; 95% CI, 0.80–0.98), in-hospital (RR, 0.93; 95% CI, 0.88–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a very small reductions in the length of hospital stay and ICU. Corticosteroids were associated with an higher risk of hypernatremia and hyperglycemia; further, they appear to have no significant effect on superinfection and gastroduodenal bleeding.Conclusions: Corticosteroids had no significant effect on the 28 and long-term mortality; however, they decreased the ICU and hospital mortality. Further, corticosteroids could increase the risk of the hypernatremia and hyperglycemia in sepsis patients.

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 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 Prevalence and risk factors of depression in patients with lung cancer: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028994 ◽  
Author(s):  
Xiao-ru Yan ◽  
Xun Chen ◽  
Peitong Zhang
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Measurement Tool ◽  
China National Knowledge Infrastructure ◽  
Assessment Development ◽  
Ethical Approval

IntroductionPatients with lung cancer often experience heavy psychological distress, especially depression, which results in poorer quality of life, shorter survival time and greater mortality. Our aim is to summarise data on the prevalence and risk factors of depression in patients with lung cancer.Methods and analysisWe will search PubMed, EMBASE, MEDLINE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang and Chinese Biomedicine Literature Database (SinoMed) for studies on the prevalence and risk factors of depression in patients with lung cancer, which should be published from 1 January 1975 to 25 November 2018 in English/Chinese. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will use RevMan V.5.0 and STATA V.12.0 software for statistical analysis. The I² test will be used to identify the extent of heterogeneity. Publication bias will be assessed by generating a funnel plot and performing the Begg and Egger test. The quality of the systematic review will be evaluated using the AMSTAR (‘A Measurement Tool to Assess Systematic Reviews’) criteria and ‘The Grading of Recommendations Assessment, Development and Evaluation’.Ethics and disseminationSince this is a review involving analysis of publicly available data, ethical approval is not required. The final results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018118167.

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 ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis in the 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 MEDLINE, Web of science, EMBASE, Scopus, and the Cochrane Library. The association between LMR and mortality/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 higher short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). In the subgroup analysis, there was still statistical significance of long-term mortality/MACE in all subgroups. Conclusions: This study suggested that lower LMR value might be associated with poor prognosis in ACS patients.

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 ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis in the 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/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 higher short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). In the subgroup analysis, there was still statistical significance of long-term mortality/MACE in all subgroups.Conclusions: This study suggested that lower LMR value might be associated with higher short-term and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

scholarly journals The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohail Akhtar ◽  
Jamal Abdul Nasir ◽  
Amara Javed ◽  
Mariyam Saleem ◽  
Sundas Sajjad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Population Based ◽  
Included Study ◽  
Cochrane Library ◽  
Or Education ◽  
Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

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