T-Score and Handgrip Strength Association for the Diagnosis of Osteosarcopenia: A Systematic Review and Meta-Analysis

Background: Osteosarcopenia is a recently identified condition caused by the coexistence of osteoporosis and sarcopenia that affects the frail elderly population, leading to an increased risk of falls and fractures. Given the recent socio-economic interest associated with osteosarcopenia, the aim of this meta-analysis is to provide an overview of the factors potentially involved in its pathogenesis, assessing its population type, prevalence, and associated variables. Methods: A comprehensive systematic search for relevant studies, published from 2015 to 2020, was performed by using PubMed, EMBASE, and Cochrane databases. We analysed the variables of age, vitamin D, handgrip, and T-score in four different groups: healthy, osteopenic–osteoporotic, sarcopenic, and osteosarcopenic. Results: A total of 6504 patients from 16 studies were included in the final meta-analysis. The analysis of the individual variables reveals a statistically significant correlation between the handgrip test data and T-score (p < 0.001). Conclusions: The correlation between T-score values and handgrip strength suggests a new potential parameter in the development of predictive models that could be used in clinical practice, highlighting its importance for the diagnosis of osteosarcopenia.

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Opioid Use and the Risk of Falls, Fall Injuries and Fractures among Older Adults: A Systematic Review and Meta-Analysis

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa038 ◽

2020 ◽

Vol 75 (10) ◽

pp. 1989-1995 ◽

Cited By ~ 3

Author(s):

Aya Yoshikawa ◽

Gilbert Ramirez ◽

Matthew Lee Smith ◽

Margaret Foster ◽

Anas K Nabil ◽

...

Keyword(s):

Older Adults ◽

Meta Analysis ◽

Effect Sizes ◽

Opioid Use ◽

Fall Injuries ◽

Risk Of Death ◽

Management Interventions ◽

Risk Estimates ◽

Increased Risk ◽

Risk Of Falls

Abstract Background There is increasing concern about opioid use as a pain treatment option among older adults. Existing literature implies an association between opioid use and fracture, increasing the risk of death and disabilities; yet, this relationship with other fall-related outcomes has not been fully explored. We performed a meta-analysis to evaluate the associations between opioid use and adverse health outcomes of falls, fall injuries, and fractures among older adults. Methods A systematic literature search was conducted using nine databases: Medline, Embase, CINAHL, PsycInfo, Global Health, Northern Light Sciences Conference Abstracts, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We log-transformed effect sizes (relative risk [RR], odds ratio [OR], and hazard ratio [HR]) to compute pooled risk estimates comparable across the studies. The random-effects model was applied to calculate the pooled risk estimates due to heterogeneity. Meta-regressions explored differences in risk estimates by analysis method, study design, setting, and study quality. Results Thirty studies, providing 34 relevant effect sizes, met the inclusion criteria for this meta-analysis. Overall, opioid use was significantly associated with falls, fall injuries, and fractures, with effect sizes ranging from 0.15 to 0.71. In meta-regressions, no selected factors explained heterogeneity. Conclusion While heterogeneity is present, results suggest an increased risk of falls, fall injuries, and fractures among older adults who used opioids. Findings highlight the need for opioid education and nonopioid-related pain management interventions among older adults to decrease fall-related risk.

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Individual Predictors of the Radical Right-Wing Vote in Europe: A Meta-Analysis of Articles in Peer-Reviewed Journals (1995–2016)

Government and Opposition ◽

10.1017/gov.2018.2 ◽

2018 ◽

Vol 53 (3) ◽

pp. 569-593 ◽

Cited By ~ 13

Author(s):

Daniel Stockemer ◽

Tobias Lentz ◽

Danielle Mayer

Keyword(s):

Meta Analysis ◽

Radical Right ◽

Political Regime ◽

Right Wing ◽

Quantitative Methodology ◽

Success Rates ◽

Quantitative Studies ◽

Individual Vote ◽

Individual Variables ◽

The Individual

In this article, we summarize the individual demand-level factors explaining the radical right-wing vote in European countries. To do so, we first review 46 quantitative peer-reviewed articles featuring the individual vote choice in favour of a radical right-wing party as the dependent variable. To identify relevant articles, we use Kai Arzheimer’s bibliography on the radical right and employ the following inclusion criterion: the articles must be written in English, they must use the individual vote for a radical right-wing party as the dependent variable, they must use a quantitative methodology and they must include some type of regression analysis. Using this strategy, we conduct a meta-analysis of 329 relevant models and find that over 20 individual variables are tested. Because many variables such as attitudes towards immigration, employment, age, education and gender only show moderate success rates in attempting to explain an individual’s propensity to vote for the radical right, we complement the review of quantitative studies with an analysis of 14 qualitative publications. The review of these qualitative works shows that the processes through which somebody becomes a voter, supporter or activist of the radical right are often more complex than the commonly used surveys can portray them. Frequently, feelings of relative economic deprivation and dissatisfaction with the political regime trigger an awakening that makes individuals seek engagement. However, the processes behind this awakening are complex and can only be partially captured by quantitative studies.

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Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8030372 ◽

2019 ◽

Vol 8 (3) ◽

pp. 372 ◽

Cited By ~ 22

Author(s):

Charat Thongprayoon ◽

Wisit Kaewput ◽

Natanong Thamcharoen ◽

Tarun Bathini ◽

Kanramon Watthanasuntorn ◽

...

Keyword(s):

Acute Kidney Injury ◽

Graft Failure ◽

Meta Analysis ◽

Random Effect ◽

Kidney Injury ◽

Incidence Rates ◽

Liver Graft ◽

Inverse Variance ◽

Increased Risk ◽

The Individual

Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies assessing the incidence of AKI (using a standard AKI definition) in adult patients undergoing LTx. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, the generic inverse variance approach of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018100664). Results: Thirty-eight cohort studies, with a total of 13,422 LTx patients, were enrolled. Overall, the pooled estimated incidence rates of post-LTx AKI and severe AKI requiring renal replacement therapy (RRT) were 40.7% (95% CI: 35.4%–46.2%) and 7.7% (95% CI: 5.1%–11.4%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of post-LTx AKI (p = 0.81). The pooled estimated in-hospital or 30-day mortality, and 1-year mortality rates of patients with post-LTx AKI were 16.5% (95% CI: 10.8%–24.3%) and 31.1% (95% CI: 22.4%–41.5%), respectively. Post-LTx AKI and severe AKI requiring RRT were associated with significantly higher mortality with pooled ORs of 2.96 (95% CI: 2.32–3.77) and 8.15 (95%CI: 4.52–14.69), respectively. Compared to those without post-LTx AKI, recipients with post-LTx AKI had significantly increased risk of liver graft failure and chronic kidney disease with pooled ORs of 3.76 (95% CI: 1.56–9.03) and 2.35 (95% CI: 1.53–3.61), respectively. Conclusion: The overall estimated incidence rates of post-LTx AKI and severe AKI requiring RRT are 40.8% and 7.0%, respectively. There are significant associations of post-LTx AKI with increased mortality and graft failure after transplantation. Furthermore, the incidence of post-LTx AKI has remained stable over the ten years of the study.

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The Metabolic SYNDROME and the RISK of Venous Thrombosis: RESULTS of AN Individual LEVEL Patient Meta-ANALYSIS

Blood ◽

10.1182/blood.v116.21.3177.3177 ◽

2010 ◽

Vol 116 (21) ◽

pp. 3177-3177

Author(s):

Francesco Dentali ◽

Cihan Ay ◽

Moon Jang ◽

Matteo di Minno ◽

Ingrid Pabinger ◽

...

Keyword(s):

Metabolic Syndrome ◽

Multivariate Analysis ◽

Conflicts Of Interest ◽

Meta Analysis ◽

Visceral Obesity ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Individual Features ◽

The Individual ◽

The Impact

Abstract Abstract 3177 Background: The metabolic syndrome (MS) is a cluster of interrelated risk factors that identify patients at increased risk of cardiovascular events. Recent studies also suggested an association between MS and venous thromboembolism (VTE). However, the role of the individual features of MS and whether MS and its features are more important than obesity alone to predict VTE remain to be established. Methods: We performed an individual patient level meta-analysis of case-control studies comparing the prevalence of MS in patients with unprovoked VTE and in controls. MEDLINE, EMBASE databases, and abstract books were searched up to January 2010. Odds ratios (OR) and 95% confidence intervals of pooled results were calculated. The influence of individual variables (age, sex, BMI and MS) on the likelihood of VTE was compared using logistic regression analysis. Multivariate analysis was subsequently performed including the individual components of MS in the place of MS. The impact of increasing number of individual components of MS on the risk of VTE was investigated. Results: Four studies were identified and analyzed, for a total of 1332 patients (479 cases and 833 controls). Mean age was 53.3 and 52.7, respectively (p=n.s.), 49.5% cases and 42.4% controls were males (p=0.0003), 38.8% and 30.0% were obese (p=0.0001). MS was significantly associated with VTE (OR 1.97, 1.57–2.47), and the association linearly increased with the number of MS features (p for trend <0.001). At multivariate analysis, MS but not obesity remained associated with VTE (OR 1.92, 1.50–2.46 and 1.14, 0.88–1.47, respectively). All individual features of MS, but HDL cholesterol, were independently associated with VTE. Conclusions: The results of this meta-analysis confirm the association between MS and VTE and suggest that MS (and visceral obesity defined by increased waist circumference) could be a more important predictor of VTE than obesity defined by BMI. Disclosures: No relevant conflicts of interest to declare.

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Outcome Measures in Spine Surgery: How Far Can we Go Building Evidence?

Journal of Orthopedics & Bone Disorders ◽

10.23880/jobd-16000161 ◽

2018 ◽

Vol 2 (3) ◽

pp. 1-14

Author(s):

Henrique Relvas

Keyword(s):

Outcome Measures ◽

Spine Surgery ◽

Meta Analysis ◽

Outcome Evaluation ◽

Health Trends ◽

Clear Cut ◽

Increased Risk ◽

The Face ◽

The Individual ◽

Spine Disorders

There is an imperative need to alleviate the actual and predictably harder burden of spine disorders and particularly the share due to chronic nonspecific low back pain, both at the individual and community - based viewpoint. Studies on global health trends charge a relevant part of the onus to the proposed invasive procedures, raising concern over its inappropriately high and growing use, counteracting clinical guidelines recommendation of a prudent selection of patients, based on clear - cut indications. Part of this gap between evidence and practice stands from questionable assumptions regarding the usefulness of surgery. Uncertainty on relative benefits and harms in the face of increased risk of adverse events, or the higher costs and health care resources i nvolved, results in controversial decision - making to plan the intervention . Improvement of knowledge about these questions can be provided by the inclusion in the research agenda of comprehensive and standardized evaluation of outcomes after spine surgery. Such a protocol procedure would enable future systematic reviews to perform a consistent meta - analysis of data from trials, mandatory for high - quality evidence gathering. Outcome evaluation requires both subjective and objective assessments. This review a ims to clarify the role of outcome measures in support of the need to build reliable information on the effectiveness of surgical treatment of spinal disorders.

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P4747Impact of different estimates of renal function on cardiovascular mortality and major bleeding in patients with atrial fibrillation on oral anticoagulation

European Heart Journal ◽

10.1093/eurheartj/ehz745.1123 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Z Hijazi ◽

C B Granger ◽

S H Hohnloser ◽

J Westerbergh ◽

J Lindback ◽

...

Keyword(s):

Atrial Fibrillation ◽

New York ◽

Cystatin C ◽

Major Bleeding ◽

Discriminatory Ability ◽

Risk Of Death ◽

Model Based ◽

Increased Risk ◽

Individual Variables ◽

The Individual

Abstract Background Renal dysfunction is associated with increased risk of cardiovascular events in atrial fibrillation (AF). Estimated glomerular filtration rate (eGFR) can be calculated by different equations based on creatinine or cystatin C. We compared different methods of assessing eGFR and their association with cardiovascular (CV) death and major bleeding in 14,980 AF patients in the ARISTOTLE trial. Methods eGFR was calculated using equations based on creatinine (Cockcroft-Gault, MDRD, and CKD-EPI) and/or cystatin C (CKD-EPIcys and CKD-EPIcys+crea). In total five eGFR equations as well as a model based on the variables within the equations were assessed. Associations were evaluated by Spearman correlation, and discriminatory ability for CV-death and major bleeding by Harrell's c-index. Results Median age was 70.0 years, and 35.6% were women. Median eGFR (mL/min) were: Cockcroft-Gault 74.1, MDRD 66.5, CKD-EPI 68.5, CKD-EPIcys 74.2, and CKD-EPIcys+crea 72.6. Correlation ranged from 0.49 (Cockroft-Gault and CKD-EPIcys) to 0.99 (MDRD and CKD-EPI). Among the eGFR equations, those based on cystatin C yielded the highest c-indices for CV-death and major bleeding, 0.628 (CKD-EPIcys) and 0.612 (CKD-EPIcys+crea), respectively. A model based on the variables within the eGFR equations (age, sex, weight, creatinine, and cystatin C) yielded the highest discriminatory value for both outcomes, 0.673 and 0.656, respectively. Figure 1 Conclusions In patients with AF on anticoagulation, correlation between eGFR methods varied greatly. Cystatin C-based eGFR seem to provide the most robust balance in reflecting the risk of death and bleeding. However, a model based on the individual variables within the eGFR equations provided the highest discriminatory value. Acknowledgement/Funding The ARISTOTLE trial was funded by Bristol-Myers Squibb, Co Princeton, NJ and Pfizer Inc., New York, NY.

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Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies

The Journals of Gerontology Series A ◽

10.1093/gerona/glz272 ◽

2019 ◽

Vol 75 (5) ◽

pp. 952-960 ◽

Cited By ~ 5

Author(s):

Silvia G R Neri ◽

Juliana S Oliveira ◽

Amabile B Dario ◽

Ricardo M Lima ◽

Anne Tiedemann

Keyword(s):

Systematic Review ◽

Older Adults ◽

Relative Risk ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Relative Risks ◽

Increased Risk ◽

Risk Of Falls

Abstract Background Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults. Methods MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses. Results Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07–1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08–1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92–1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63–0.68). Conclusions Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age.

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Risk of Fractures in Stroke Patients Treated With a Selective Serotonin Reuptake Inhibitor

Stroke ◽

10.1161/strokeaha.120.032973 ◽

2021 ◽

Author(s):

Joshua S. Jones ◽

Rina Kimata ◽

Osvaldo P. Almeida ◽

Graeme J. Hankey

Keyword(s):

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Bone Fractures ◽

Meta Analysis ◽

Grey Literature ◽

Selective Serotonin ◽

Bibliographic Databases ◽

Stroke Survivors ◽

Increased Risk ◽

Risk Of Falls

Background and Purpose: Stroke survivors have an increased risk of depression and bone fractures. Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of fractures in observational studies. Several randomized controlled trials (RCTs) reporting the effect of SSRIs on the risk of fractures in stroke survivors have been published recently but have not been subject to a meta-analysis. We aimed to determine the risk of fractures associated with the use of SSRIs, and the risk of falls, seizures, and recurrent strokes as possible mediators of fractures, in stroke survivors. Methods: We conducted a systematic review and meta-analysis of RCTs of SSRIs in stroke survivors according to a protocol registered in PROSPERO (CRD42020192632). Web of Science, EMBASE, PsycINFO, and Ovid Medline/PubMed bibliographic databases, clinical trial registers, and grey literature sources were searched. RCTs of SSRIs versus placebo or no intervention that report the risk of fractures in adult survivors of hemorrhagic or ischemic stroke were included. Two reviewers independently screened search results and extracted data. Meta-analyses were conducted for each outcome using the Mantel-Haenszel random-effects models. Results: The searches yielded 683 records, of which 4 RCTs of 6 months duration with a total of 6549 participants were included in the meta-analysis: 3 studies of fluoxetine and 1 study of citalopram. Treatment with an SSRI for 6 months increased the risk of fractures with a risk ratio of 2.36 (95% CI, 1.64–3.39) compared with placebo. The risk of falls, seizures, and recurrent stroke was not statistically significantly increased. Only studies of fluoxetine and citalopram were available for inclusion in the review, and hence the generalizability of the findings to other SSRIs is uncertain. Conclusions: Based on available RCTs of fluoxetine and citalopram, SSRIs used for 6 months doubled the risk of fractures in stroke survivors. Registration: URL: https://www.crd.york.ac.uk/prospero/ ; Unique identifier: CRD42020192632.

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Preparing for the Future Impacts of Megastorms on Archaeological Sites: An Evaluation of Flooding from Hurricane Harvey, Houston, Texas

American Antiquity ◽

10.1017/aaq.2018.85 ◽

2019 ◽

Vol 84 (2) ◽

pp. 292-301 ◽

Cited By ~ 3

Author(s):

Leslie A. Reeder-Myers ◽

Mark D. McCoy

Keyword(s):

Climate Change ◽

Spatial Models ◽

Remote Sensing Data ◽

Field Research ◽

Archaeological Site ◽

Archaeological Sites ◽

Cultural Resources ◽

Increased Risk ◽

Individual Variables ◽

The Individual

Powerful hurricanes in 2017—Hurricanes Harvey, Irma, and Maria—were stark examples of how these previously rare catastrophes are becoming increasingly normal due to climate change, with dire consequences for cultural resources. These storms, sometimes called megastorms or superstorms, were the first in which high-resolution satellite imagery was available in the immediate aftermath, providing a new tool for rapidly evaluating damage to archaeological sites. Using Hurricane Harvey as a case study, we examined two recent spatial models of archaeological site vulnerability to long-term climate change to determine whether these models are also adequate for predicting the impacts of short-term climate catastrophes. We further examined a number of individual variables that we expected to be useful in predicting which sites would be most vulnerable to flooding, such as proximity to rivers, the coast, or the floodplain. Neither the models nor the individual variables correlated well to increased risk to archaeological sites, with the exception of land use. Sites located within developed areas benefited from measures to protect property and were less often flooded. We suggest that strategies for responding to megastorms would be most effective through a combination of preparedness, analysis of remote sensing data, and existing field research methods.

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The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies

Psychological Medicine ◽

10.1017/s0033291713001438 ◽

2013 ◽

Vol 44 (4) ◽

pp. 797-810 ◽

Cited By ~ 226

Author(s):

S. Lev-Ran ◽

M. Roerecke ◽

B. Le Foll ◽

T. P. George ◽

K. McKenzie ◽

...

Keyword(s):

Longitudinal Studies ◽

Depressive Disorders ◽

Meta Analysis ◽

Cannabis Use ◽

Cumulative Exposure ◽

Control Variables ◽

Increased Risk ◽

Study Characteristics ◽

The Individual

BackgroundLongitudinal studies reporting the association between cannabis use and developing depression provide mixed results. The objective of this study was to establish the extent to which different patterns of use of cannabis are associated with the development of depression using meta-analysis of longitudinal studies.MethodPeer-reviewed publications reporting the risk of developing depression in cannabis users were located using searches of EMBASE, Medline, PsychINFO and ISI Web of Science. Only longitudinal studies that controlled for depression at baseline were included. Data on several study characteristics, including measures of cannabis use, measures of depression and control variables, were extracted. Odds ratios (ORs) were extracted by age and length of follow-up.ResultsAfter screening for 4764 articles, 57 articles were selected for full-text review, of which 14 were included in the quantitative analysis (total number of subjects = 76058). The OR for cannabis users developing depression compared with controls was 1.17 [95% confidence interval (CI) 1.05–1.30]. The OR for heavy cannabis users developing depression was 1.62 (95% CI 1.21–2.16), compared with non-users or light users. Meta-regression revealed no significant differences in effect based on age of subjects and marginal difference in effect based on length of follow-up in the individual studies. There was large heterogeneity in the number and type of control variables in the different studies.ConclusionsCannabis use, and particularly heavy cannabis use, may be associated with an increased risk for developing depressive disorders. There is need for further longitudinal exploration of the association between cannabis use and developing depression, particularly taking into account cumulative exposure to cannabis and potentially significant confounding factors.

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