Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis

There is an association between smoking and suicide, even though the direction and nature of this relationship remains controversial. This meta-analysis aimed to evaluate the association between smoking and suicidal behaviours (ideation, planning, suicide attempts, and death by suicide). On 24 August 2020, we searched the PubMed, Cochrane library, Scopus, Web of Science, TRIP, and SCIENCE DIRECT databases for relevant articles on this topic. Twenty prospective cohort studies involving 2,457,864 participants were included in this meta-analysis. Compared with never smokers, former and current smokers had an increased risk of death by suicide (relative risk [RR] = 1.31; 95% CI [1.13, 1.52] and RR = 2.41; 95% CI [2.08, 2.80], respectively), ideation (RR = 1.35; 95% CI [1.31, 1.39] and RR = 1.84; 95% CI [1.21, 2.78]), and attempted suicide (RR = 1.27; 95% CI [0.56, 2.87] and RR = 1.71; 95% CI [0.73, 3.97]). Moreover, compared to never smokers, current smoker women (RR = 2.51; 95% CI [2.06–3.04] had an increased risk of taking their own life (Q = 13,591.53; p < 0.001) than current smoker men (RR = 2.06; 95% CI [1.62–2.62]. Furthermore, smoking exposure (former and current smokers) was associated with a 1.74-fold increased risk (95% CI [1.54, 1.96]) of suicidal behaviour (death by suicide, ideation, planning, or attempts). Thus, because of the prospective relationship between smoking and suicidal behaviours, smoking should be included in suicide risk scales as a useful and easy item to evaluate suicide risk.

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Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

Virology Journal ◽

10.1186/s12985-021-01604-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Yanli Liu ◽

Yilong Pan ◽

Yuyao Yin ◽

Wenhao Chen ◽

Xiaodong Li

Keyword(s):

Fixed Effects ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Risk Of Death ◽

Potential Association ◽

Increased Risk ◽

Language Restriction ◽

Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

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Suicide Ideation and Attempts in Children With Psychiatric Disorders and Typical Development

Crisis ◽

10.1027/0227-5910/a000284 ◽

2015 ◽

Vol 36 (1) ◽

pp. 55-60 ◽

Cited By ~ 16

Author(s):

Susan Dickerson Mayes ◽

Susan L. Calhoun ◽

Raman Baweja ◽

Fauzia Mahr

Keyword(s):

Children And Adolescents ◽

Psychiatric Disorders ◽

Suicide Risk ◽

Suicide Ideation ◽

Suicide Attempts ◽

Typical Development ◽

Oppositional Defiant ◽

Suicide Behavior ◽

Increased Risk ◽

Inattentive Type

Background: Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. Aims: This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Method: Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6–18 years of age. Results: For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0–4% of patients in the other psychiatric groups. Conclusion: It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

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Cigarette Smoking Status, Cigarette Exposure, and Duration of Abstinence Predicting Incident Dementia and Death: A Multistate Model Approach

Journal of Alzheimer s Disease ◽

10.3233/jad-201332 ◽

2021 ◽

Vol 80 (3) ◽

pp. 1013-1023

Author(s):

Adrienne L. Johnson ◽

Naomi C. Nystrom ◽

Megan E. Piper ◽

Jessica Cook ◽

Derek L. Norton ◽

...

Keyword(s):

Cigarette Smoking ◽

Competing Risks ◽

Smoking Status ◽

Risk Of Death ◽

Incident Dementia ◽

Smoking Exposure ◽

Increased Risk ◽

State Models ◽

Never Smokers ◽

The Impact

Background: To fully characterize the risk for dementia associated with cigarette smoking, studies must consider competing risks that hinder the observation of dementia or modify the chance that dementia occurs (i.e., death). Extant research examining the competing risks fails to account for the occurrence of death following dementia, limiting our understanding of the relation between smoking and dementia. Objective: Examine the impact of smoking status, lifetime smoking exposure, and duration of abstinence on incident dementia, death following dementia, and death without dementia. Methods: Multi-state models estimated hazard ratios (HR) for 95% confidence interval (CI) of 10,681 cognitively healthy adults for transition from baseline to dementia, baseline to death, and dementia to death based on smoking status, lifetime cigarette exposure, and abstinence duration. Results: Compared to never smokers, current smokers had increased risk of dementia (HR = 1.66; 95% CI 1.18– 2.32; p = 0.004), and death from baseline (HR = 2.98; 95% CI 2.24– 3.98; p < 0.001) and incident dementia (HR = 1.88; 95% CI 1.08– 3.27; p = 0.03). Pack years increased risk of death from baseline (HR = 1.01; 95% CI 1.00– 1.01; p < 0.001), but not dementia risk (HR = 1.00; 95% CI 1.00– 1.00; p = 0.78) or death following dementia (HR = 1.01; 95% CI 1.00– 1.01; p = 0.05). Recent quitters (quit < 10 years), compared to never smokers, had increased risk of death after baseline (HR = 2.31; 95% CI 1.55– 3.43; p < 0.001), but not dementia (HR = 1.17; 95% CI 0.73– 1.88; p = 0.52) or death following dementia (HR = 1.01; 95% CI 0.42– 2.41; p = 0.99). Conclusion: Current smoking increases the risk for dementia and death, but dementia is better attributed to smoking recency than lifetime exposure. Smoking cessation at any age might reduce these risks for cognitively healthy individuals.

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Cigarette smoking and the risk of nasopharyngeal carcinoma: a meta-analysis of epidemiological studies

BMJ Open ◽

10.1136/bmjopen-2017-016582 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016582 ◽

Cited By ~ 11

Author(s):

Mengjuan Long ◽

Zhenming Fu ◽

Ping Li ◽

Zhihua Nie

Keyword(s):

Nasopharyngeal Carcinoma ◽

Cigarette Smoking ◽

Reference Group ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Eligibility Criteria ◽

Increased Risk ◽

Undifferentiated Type ◽

Never Smokers

ObjectiveThe role of cigarette smoking as an independent risk factor for patients with nasopharyngeal carcinoma (NPC) is controversial. We attempted to provide evidence of a reliable association between cigarette smoking and the risk of NPC.DesignMeta-analysis.Data sourcesPubMed online and the Cochrane Library of relevant studies published up to February 2016.Eligibility criteriaAll studies had to evaluate the relationship between NPC and cigarette smoking with never smokers as the reference group.OutcomesThe primary outcome was the adjusted OR, RR or HR of NPC patients comparing smoking with never-smoking; the second was the crude OR, RR or HR.ResultsWe identified 17 case–control studies and 4 cohort studies including 5960 NPC cases and 429 464 subjects. Compared with never smokers, current smokers and ever smokers had a 59% and a 56% greater risk of NPC, respectively. A dose–response relationship was identified in that the risk estimate rose by 15% (p<0.001) with every additional 10 pack-years of smoking, and risk increased with intensity of cigarette smoking (>30 cigarettes per day). Significantly increased risk was only found among male smokers (OR, 1.36; 95% CI 1.15 to 1.60), not among female smokers (OR, 1.58; 95% CI 0.99 to 2.53). Significantly increased risk also existed in the differentiated (OR, 2.34; 95% CI 1.77 to 3.09) and the undifferentiated type of NPC (OR, 1.15; 95% CI 0.90 to 1.46). Moreover, people who started smoking at younger age (<18 years) had a greater risk than those starting later for developing NPC (OR, 1.78; 95% CI 1.41 to 2.25).ConclusionsCigarette smoking was associated with increased risk of NPC, especially for young smokers. However, we did not find statistical significant risks of NPC in women and in undifferentiated type, which might warrant further researches.

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Smoking and Hodgkin Lymphoma: A Meta-Analysis

Blood ◽

10.1182/blood.v112.11.4829.4829 ◽

2008 ◽

Vol 112 (11) ◽

pp. 4829-4829

Author(s):

Sheila Pascual ◽

Cannon Milani ◽

Joanna Mitri ◽

Jorge Castillo

Keyword(s):

Hodgkin Lymphoma ◽

Tobacco Use ◽

Case Reports ◽

Meta Analysis ◽

Case Control ◽

Current Smoker ◽

Case Control Studies ◽

Increased Risk ◽

Former Smokers ◽

Never Smokers

Abstract INTRODUCTION: The etiology of Hodgkin lymphoma (HL) is largely unknown. However, certain associations have been noted, such as familial factors and infection with viruses. Smoking has been associated with the development of multiple malignancies and some studies have reported an association between HL and smoking but the relationship of tobacco use with lymphomas in largely unclear. OBJECTIVE: To investigate the potential relationship between tobacco use and the development of HL using a meta-analysis methodology of retrospective, case-control studies. METHODS: An extensive search was conducted using Pubmed/MEDLINE through July 2008. Case-control studies that reported odds ratio (OR) and 95% confidence intervals (CI) or allow for those values to be calculated were included in our analysis. Case reports, editorials, letters to the editor, review articles and prospective studies were excluded. The smoking status was then subdivided in three groups: never smokers, former smokers and current smokers. Meta-analyses were performed comparing the risks of former and current smokers against the risk of never smokers of developing HL. Fixed and random effects models were used to assess for heterogeneity. RESULTS: Seven case-controls studies, accounting for 3201 cases and 15268 controls were included in the analysis. Most of the articles reported OR adjusted for age, sex and educational level. In former smokers, the OR was 0.73 (95% CI, 0.65 – 0.82) when compared to never smokers; no heterogeneity was detected. The current smoker group had an OR of 1.70 (95% CI, 1.36 – 2.13) when compared to the never smoker group; some heterogeneity was detected in this group (p < 0.003, I2 = 69.6%). CONCLUSIONS: Despite the heterogeneity observed in the analysis, the current smoker group seems to have a 70% increased risk of developing HL. Although a cause-effect linkage between tobacco use and HL is difficult to prove, further basic and translational research is necessary to clarify the potential etiological role of smoking in HL.

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Meta-analysis for the Relationship Between Hyperuricemia and CVD Incidence

10.21203/rs.3.rs-936526/v1 ◽

2021 ◽

Author(s):

YEYI YANG ◽

CHUNJIAO LONG ◽

ZUOCHENG YANG ◽

YEZHEN YANG

Keyword(s):

Uric Acid ◽

Meta Analysis ◽

Cochrane Library ◽

Outcome Indicators ◽

Risk Of Death ◽

The Past ◽

Increased Risk ◽

Endogenous Antioxidant ◽

The Relationship ◽

Exact Relationship

Abstract BACKGROUND: Uric acid was once considered an effective endogenous antioxidant, but now more and more evidence shows that it may play a significant role in the pathophysiology of cardiovascular diseases.OBJECTIVES: It has not been clear that UA is a sign of poor prognosis or a risk factor for CVD. Our aim is to figure out the exact relationship between CVD and uric acid. METHODS: We studied 3356 publications in the past 44 years through MEDLINE, EMBASE, and Cochrane library searches, and selected 22 studies that met our inclusion criteria. RESULTS: The meta-analysis showed that hyperuricemia was associated with an increased risk of death from CVD (RR=1.37; 95% CI:1.29-1.45; I2=31.4%, P=0.157). Sensitivity analysis reviewed several potential sources of heterogeneity between studies, such as average SUA level, study location, and outcome indicators.

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The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

PLoS ONE ◽

10.1371/journal.pone.0256480 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256480

Author(s):

Xiaofang Fu ◽

Yonghong Zhong ◽

Wucheng Xu ◽

Jiangang Ju ◽

Min Yu ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Embolism ◽

Confidence Intervals ◽

Meta Analysis ◽

Fatal Outcome ◽

Cochrane Library ◽

Chronic Obstructive ◽

Risk Of Death ◽

Copd Patients ◽

Increased Risk

Background The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies. Methods We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively. Results A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97–23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06–5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51–4.00), higher heart rates (MD = 20.51, 95% CI: 4.95–36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01–4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80–2.23), WBC counts (MD = 1.42, 95% CI: 0.14–2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43–3.50). Conclusions The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE. Prospero registration number CRD42021226568.

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Association of Steroids Use with Survival in Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

Cancers ◽

10.3390/cancers12030546 ◽

2020 ◽

Vol 12 (3) ◽

pp. 546 ◽

Cited By ~ 12

Author(s):

Fausto Petrelli ◽

Diego Signorelli ◽

Michele Ghidini ◽

Antonio Ghidini ◽

Elio Gregory Pizzutilo ◽

...

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Symptom Control ◽

Cochrane Library ◽

Risk Of Death ◽

Increased Risk

Immune checkpoint inhibitors (ICIs) can elicit toxicities by inhibiting negative regulators of adaptive immunity. Sometimes, management of toxicities may require systemic glucocorticoids. We performed a systematic review and meta-analysis of published studies to evaluate the correlation between steroids use, overall survival (OS), and progression-free survival (PFS) in cancer patients treated with ICIs. Publications that compared steroids with non-steroid users in cancer patients treated with ICIs from inception to June 2019 were identified by searching the EMBASE, PubMed, SCOPUS, Web of Science, and Cochrane Library databases. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Patients (studies, n = 16; patients, n = 4045) taking steroids were at increased risk of death and progression compared to those not taking steroids (HR = 1.54, 95% CI: 1.24–1.91; p = 0.01 and HR = 1.34, 95% CI: 1.02–1.76; p = 0.03, respectively). The main negative effect on OS was associated with patients taking steroids for supportive care (HR = 2.5, 95% CI 1.41–4.43; p < 0.01) or brain metastases (HR = 1.51, 95% CI 1.22–1.87; p < 0.01). In contrast, steroids used to mitigate adverse events did not negatively affect OS. In conclusion, caution is needed when steroids are used for symptom control. In these patients, a negative impact of steroid use was observed for both OS and PFS.

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Clopidogrel non-responsiveness and risk of cardiovascular morbidity

Thrombosis and Haemostasis ◽

10.1160/th09-06-0418 ◽

2010 ◽

Vol 103 (04) ◽

pp. 00-00 ◽

Cited By ~ 112

Author(s):

Rossella Marcucci ◽

Anna Maria Gori ◽

Betti Giusti ◽

Rosanna Abbate ◽

Gian Franco Gensini ◽

...

Keyword(s):

Platelet Reactivity ◽

Meta Analysis ◽

Significant Risk ◽

Poor Response ◽

Coronary Intervention ◽

Cochrane Library ◽

Risk Of Death ◽

Increased Risk ◽

Coronary Events ◽

Artery Disease

SummaryWe performed this meta-analysis to update the clinical evidences on the relation between clopidogrel non-responsiveness and clinical outcomes in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention. An electronic literature search through MEDLINE, EMBASE, Web of Science, and the Cochrane Library and bibliographies of retrieved articles up to January, 2009 was conducted. Studies were included if they had a cohort prospective design, if they analysed clopidogrel responsiveness in CAD patients in relation to death and/or occurrence of adverse coronary events during follow-up, and if they reported an adequate statistical analysis. Fourteen studies, totalling 4,564 CAD patients followed for a time ranging from 14 days to one year, were included. The cumulative analysis reported that residual platelet reactivity despite clopidogrel treatment was significantly associated with an increased risk of death and/or thrombotic recurrences (odds ratio [OR] 5.67, 95% confidence interval [CI] 2.97 to 10.84; p<0.00001). However, four studies contributed to a consistent heterogeneity of the model and evidenced a significant risk of publication bias, so were excluded from the analysis. This exclusion, however, did not influence the overall result, by confirming the increased risk of cardiovascular recurrences for patients with a poor response to clopidogrel treatment (OR 3.58, 95%CI 2.54 to 5.05; p<0.00001). The present updated meta-analysis documents a significant association between residual platelet reactivity under clopidogrel treatment and recurrent cardiovascular events, so suggesting the relevance of ongoing interventional studies aimed at tailoring the antithrombotic therapy in CAD patients.

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Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Emergency Medicine International ◽

10.1155/2019/4654705 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12

Author(s):

Zhen Chen ◽

Xuxia Wei ◽

Genglong Liu ◽

Qiang Tai ◽

Donghua Zheng ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Randomized Clinical Trials ◽

Distress Syndrome ◽

Meta Analysis ◽

Cochrane Library ◽

Risk Of Death ◽

Increased Risk ◽

Ventilated Patients

Objectives. Driving pressure (DP) has recently become a promising mediator for the identification of the effects of mechanical ventilation on outcomes in acute respiratory distress syndrome (ARDS). The aim of this study was to systematically and quantitatively update and assess the association between DP and mortality among ventilated patients with ARDS. Methods. PubMed, the Cochrane Library, ISI Web of Knowledge, and Embase were systematically searched from inception to June 2018. Two investigators conducted the literature search study selection, data extraction, and quality evaluation independently. RevMan 5.3 software was used for all statistical analyses. Results. A total of seven studies comprising 8010 patients were included in this meta-analysis. Higher DP showed a significant association with higher mortality (pooled risk ratio, 1.10; 95% [CI], 1.05–1.16; I2 =58%). Sensitivity analysis indicated that one study significantly affected the stability of pooled results. One of the subgroups investigated, ARDS severity, could account for the heterogeneity. An exploratory post hoc subgroup analysis and higher DP significantly increased mortality in the mild to severe ARDS subgroup (RR 1.28; 95% [CI], 1.14–1.43; I2 =0), but not in the moderate to severe ARDS subgroup (RR 1.18; 95% [CI], 0.95–1.46; I2 =52%). Conclusion. Higher DP was significantly associated with an increased risk of death among ventilated patients with ARDS. But it did not seem to predict prognosis to moderate to severe ARDS. Future prospective randomized clinical trials are needed to verify the results of this meta-analysis and address the unresolved questions about optimum cutoff values for DP. Trial Registration. This trial is registered with PROSPERO (CRD42018102146), on 11 August 2018.

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