scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

2021 ◽  
Author(s):  
Kate Evans ◽  
Hannah Fraser ◽  
Olalekan Uthman ◽  
Osemeke Osokogu ◽  
Samantha Johnson ◽  
...  

Abstract Background: Previous research is inconclusive on the effects of mode of delivery on maternal health-related quality-of-life. We conducted a systematic review and meta-analysis to assess the current evidence for associations between mode of delivery and postpartum health-related quality-of-life. Methods: Electronic databases MEDLINE ALL (OVID), Web of Science, The Cochrane Library, CINAHL and EMBASE (OVID) were searched for English written articles investigating the relationship between mode of delivery and quality-of-life published form inception to 15th October 2020. Two reviewers independently screened titles and abstracts, assessed full texts, and extracted data. Meta-analysis was conducted where possible.Results: Twenty-one studies, including 19,879 women, met the inclusion criteria. A meta-analysis of 18 studies found HRQoL scores were significantly higher for women after vaginal delivery in comparison to caesarean (emergency and elective combined) (Effect Size (ES) 0.17, 95% CI 0.01-0.25, n=7665) with highest scores after assisted vaginal delivery (ES 0.21, 95% CI 0.13-0.30, n=2547). Physical functioning (ES 11.18, 95% CI=2.29-20.06, n=1746), physical role (ES 13.10, 95% CI=1.16-25.05, n=1471), vitality (ES 6.31, 95% CI=1.14-10.29, n=1746) and social functioning (ES 5.69, 95% CI=1.26-10.11, n=1746) were significantly higher after vaginal delivery compared to caesarean. There was no significant difference in bodily pain, emotion role, mental health and general health scores were higher after vaginal delivery compared to caesarean.Conclusions: Health-related quality-of-life scores were higher for women after vaginal delivery in comparison to caesarean section. Consequently, women should be encouraged to deliver vaginally where possible. The findings of this research should be available to the relevant population to help support informed choice


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
CAJ Van Der Heijden ◽  
E Bidar ◽  
R Vos ◽  
J Maessen ◽  
T Athanasiou ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background Although one-year success of arrhythmia surgery for atrial fibrillation (AF) has long been defined as freedom from supraventricular tachyarrhythmia, patient-reported quality of life (QOL) has become increasingly important. Purpose We aimed to analyze current evidence of QOL following both concomitant and stand-alone arrhythmia surgery for AF. Methods Studies reporting on QOL of patients undergoing arrhythmia surgery for AF, stand-alone or concomitant, who provided essential data for the analysis, were included in this systematic review. A meta-analysis was performed on inter-study heterogeneity of changes in QOL in 9 of 12 included studies who used the Short-Form (SF) 36 tool. The metric standardized mean difference (SMD) was used to compare one year outcomes with baseline scores per variable of the SF-36 QOL questionnaire (total patients n = 545). Finally, meta-regression based on rhythm outcome after one year and add-on arrhythmia surgery as covariate were performed. Results QOL scores improved one year after surgical ablation for AF, evaluated by several questionnaires. In standalone arrhythmia procedures, meta-regression showed a significant improvement between the QOL and the procedural effectiveness after one year (Physical Functioning p = 0.015, Role Physical p = 0.006, General Health p = 0.002, Social Functioning p = 0.043. Forest plot Physical Functioning: SMD = 1.105; heterogeneity: I²=90.6%, p < 0.001). While this association was also suggested in concomitant procedures, only the variable Physical Role demonstrated a significant improvement when comparing QOL of cardiac surgery with and without add-on surgical AF ablation (p = 0.037). Conclusion Arrhythmia surgery for AF improves QOL. Both in standalone and concomitant procedures, the improvement in QOL seems to be related to the procedural effectiveness to maintain sinus rhythm after 12 months. Abstract Figure. SF-36 variable Physical Functioning


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuo Liu ◽  
Fan Yang ◽  
Yifan Lou ◽  
Wei Zhou ◽  
Feng Tong

Objective: Depression is one of the most common problems faced by older adults. Reminiscence therapy, defined as using the recall of past events, feelings, and thoughts facilitating pleasure, is one type of psychotherapy that could alleviate depressive feelings among older adults, improve their quality of life, and help them live independently. Reminiscence therapy originated from geriatric psychiatry, and is an effective non-pharmacological intervention that could be structured or unstructured and be conducted individually or in a group. The current systematic review was designed to summarize and review existing evidence on the effect of reminiscence therapy on depression in older adults.Methods: We conducted a systematic review from January 2000 to Mar 2021 using 10 electronic databases in English and Chinese languages, including Medline, Embase, Cinahl, PsychInfo, Cochrane, Web of Science, Google Scholar, Science Direct, CNKI, and WANFANG. We excluded studies that didn't use randomized controlled trials (RCT) from the meta-analysis. The selected studies were scored using the Cochrane Risk of Bias tool. The RevMan 5.0 was used in subgroup analysis depending on how the interventions were classified.Results: We extracted 527 studies based on keyword searches, of which 10 RCTs met inclusion criteria were included in the meta-analysis. The meta-analysis yielded high heterogeneity, and the analyses of significant subgroups showed that reminiscence therapy has a significant effect on relieving depressive symptoms in older adults. Reminiscence therapy benefits older adults with chronic illness and those on antidepressants as well. The effect and cost-effectiveness of group reminiscence therapy were higher than individual reminiscence therapy. And some specific types of group reminiscence therapy have a significant effect on improving depression and secondary outcomes, including life satisfaction. Although the effectiveness of structured and unstructured group reminiscence on depression has no significant differences according to current evidence, the structured therapy is more replicable, generalizable, and user-friendly due to its detailed protocol for new therapists. Furthermore, reminiscence therapy is more effective for older women and older adults with more severe depressive symptoms.Conclusion: Reminiscence therapy significantly increased older adults' remission from depression and quality of life immediately after the intervention. However, the evidence-based protocol and implementation of reminiscence interventions need to be further developed and standardized to facilitate global use. Moreover, it remains unclear on the long-term effect of reminiscence therapy. Based on the limitations of the current study, more rigorous evidence is needed from studies with large sample sizes, RCT design, and longer follow-up periods. Future studies could also explore the effect of different types of reminiscence therapy. Furthermore, qualitative data should be included to better understand older adults' narrative and experiences with reminiscence therapy. Future studies could also investigate the impact of reminiscence therapy on older relatives as a part of outcome measure to explore the efficacious mechanism of reminiscence therapy in alleviating older adults' depressive symptoms.


2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ching-Ching Peng ◽  
Chia-Yu Liu ◽  
Nai-Rong Kuo ◽  
Tao-Hsin Tung

Background. The effect of phytoestrogen on postmenopausal quality of life is unclear. This study evaluated the effects of phytoestrogen supplement on quality of life for postmenopausal women. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials on the effects of phytoestrogen supplements on the quality of life of postmenopausal women. We searched PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials on March 31, 2018, for relevant randomized controlled trials. Two authors independently selected studies, assessed risk of bias, and extracted data. Disagreement was resolved through discussion with a third author. Results. We involved 10 articles in the systematic review. 8 studies and a total of 1,129 subjects were included in the meta-analysis. The questionnaires used in the evaluation of quality of life were as follows: SF-36, 4 studies; MENQOL, 4 studies; For Short Form 36 surveys, phytoestrogen groups scored significantly higher for body pain (mean difference = 3.85, 95% confidence interval [CI] = [1.14, 6.57], P < 0.01), mental health (mean difference = 4.01, 95% CI = [1.49, 6.57], P < 0.01), and role limitations caused by emotional problems domains (mean difference = 3.83, 95% CI = [1.81, 5.85], P < 0.01). No statistically significant difference was obtained from Menopause-Specific Quality of Life surveys (vasomotor domain mean difference 0.14, 95% CI = [−0.08, 0.36], P = 0.20; physical domain mean difference 0.20, 95% CI [−0.08, 0.48], P = 0.15; psychological domain mean difference −0.10, 95% CI [−0.26, 0.07], P = 0.27; sexual domain mean difference −0.17, 95% CI [−0.42, 0.09], P = 0.19). Conclusion. Current evidence does not support phytoestrogen supplementation improving postmenopausal quality of life. Further comprehensive trials or long-term follow-up studies are warranted.


2018 ◽  
Vol 77 (2) ◽  
pp. 116-127 ◽  
Author(s):  
Alison I C Donaldson ◽  
Toby O Smith ◽  
Sarah Alder ◽  
Alexandra M Johnstone ◽  
Baukje De Roos ◽  
...  

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