Faculty Opinions recommendation of Factors associated with long-term mortality after Fontan procedures: a systematic review.

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

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A Systematic Review and Meta-analysis of Gender Differences in Long-term Mortality and Cardiovascular Events in Peripheral Artery Disease

Journal of Vascular Surgery ◽

10.1016/j.jvs.2020.09.039 ◽

2020 ◽

Author(s):

Saman L. Parvar ◽

Anand Thiyagarajah ◽

Nitesh Nerlekar ◽

Peta King ◽

Stephen J. Nicholls

Keyword(s):

Systematic Review ◽

Gender Differences ◽

Peripheral Artery Disease ◽

Cardiovascular Events ◽

Meta Analysis ◽

Peripheral Artery ◽

Artery Disease ◽

Long Term Mortality

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Comparison of Prognostic Accuracy of the quick Sepsis-Related Organ Failure Assessment between Short- & Long-term Mortality in Patients Presenting Outside of The Intensive Care Unit - A Systematic Review & Meta-analysis

10.1101/296459 ◽

2018 ◽

Cited By ~ 1

Author(s):

TOH LEONG TAN ◽

Ying Jing Tang ◽

Ling Jing Ching ◽

Noraidatulakma Abdullah ◽

Hui-min Neoh

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Short Term ◽

Suspected Infection ◽

Failure Assessment ◽

Short Term Mortality ◽

Short And Long Term ◽

Qsofa Score ◽

Long Term Mortality

Objective: In year 2016, quick Sepsis-Related Organ Failure Assessment (qSOFA) was introduced as a better sepsis screening tool compared to systemic inflammatory response syndrome (SIRS). The purpose of this systematic review and meta-analysis is to evaluate the ability of the qSOFA in predicting short- and long-term mortality among patients outside the intensive care unit setting. Method: Studies reporting on the qSOFA and mortality from MEDLINE (published between 1946 and 15th December 2017) and SCOPUS (published before 15th December 2017). Hand-checking of the references of relevant articles was carried out. Studies were included if they involved inclusion of patients presenting to the ED; usage of Sepsis-3 definition with suspected infection; usage of qSOFA score for mortality prognostication; and written in English. Study details, patient demographics, qSOFA scores, short-term (<30 days) and long-term (≥30 days) mortality were extracted. Two reviewers conducted all reviews and data extraction independently. Results and Discussion: A total of 39 studies met the selection criteria for full text review and only 36 studies were inclided. Data on qSOFA scores and mortality rate were extracted from 36 studies from 15 countries. The pooled odds ratio was 5.5 and 4.7 for short-term and long-term mortality respectively. The overall pooled sensitivity and specificity for the qSOFA was 48% and 85% for short-term mortality and 32% and 92% for long-term mortality, respectively. Studies reporting on short-term mortality were heterogeneous (Tau=24%, I2=94%, P<0.001), while long-term mortality studies were homogenous (Tau=0%, I2<0.001, P=0.52). The factors contributing to heterogeneity may be wide age group, various clinical settings, variation in the timing of qSOFA scoring, and broad range of clinical diagnosis and criteria. There was no publication bias for short-term mortality analysis. Conclusion: qSOFA score showed a poor sensitivity but moderate specificity for both short and long-term mortality prediction in patients with suspected infection. qSOFA score may be a cost-effective tool for sepsis prognostication outside of the ICU setting.

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Short- and long-term mortality associated with new-onset atrial fibrillation after coronary artery bypass grafting: A systematic review and meta-analysis

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2010.10.040 ◽

2011 ◽

Vol 141 (5) ◽

pp. 1305-1312 ◽

Cited By ~ 78

Author(s):

Roop Kaw ◽

Adrian V. Hernandez ◽

Iqbal Masood ◽

A. Marc Gillinov ◽

Walid Saliba ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Meta Analysis ◽

Artery Bypass ◽

Bypass Grafting ◽

Short And Long Term ◽

Onset Atrial Fibrillation ◽

Long Term Mortality ◽

New Onset

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Obesity and 1-Year Mortality in Adults After Sepsis: A Systematic Review

Biological Research For Nursing ◽

10.1177/1099800419876070 ◽

2019 ◽

Vol 22 (1) ◽

pp. 103-113

Author(s):

Jamie Robinson ◽

Theresa Swift-Scanlan ◽

Jeanne Salyer

Keyword(s):

Systematic Review ◽

Obesity Paradox ◽

Obese Patients ◽

Sepsis Mortality ◽

Number Of Patients ◽

Comprehensive Search ◽

Nonobese Patients ◽

Comprehensive Search Strategy ◽

Long Term Mortality

Purpose: In recent years, researchers have noted an “obesity paradox,” where individuals with obesity survive sepsis at higher rates than their nonobese counterparts. This systematic review summarizes the literature on studies examining the association between obesity and 1-year mortality among patients admitted with sepsis, severe sepsis, or septic shock. Materials and Methods: Using a comprehensive search strategy, a systematic review was conducted to identify studies examining the association of obesity and sepsis mortality. PubMed, Cumulative Index of Nursing and Allied Health Literature, and Elton B. Stephens Company host databases were searched for the terms sepsis, obesity, mortality, and adult. Results: The initial search identified 189 studies, 9 of which met inclusion criteria. Of these, four provided evidence that obese or very obese patients with sepsis have lower mortality than nonobese patients. Methodologic differences in the remaining five studies, which reported conflicting results, limit generalizability. Conclusion: This systematic review on the association of obesity and sepsis mortality found three studies that demonstrated lower sepsis mortality among obese patients in the first 30 days and one showing that this protective effect extends up to 1 year. Given the increased number of patients surviving sepsis, it is important to consider long-term mortality and further describe the variables associated with increased survival.

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