Prognostic implication of hypocalcaemia in COVID-19: a systematic review

2021 ◽  
Vol 22 (2) ◽  
pp. 124-132
Author(s):  
T.A. Azeez ◽  
S. Lakoh ◽  
O.T. Bamidele ◽  
E. Ekhaiyeme ◽  
S.A. Nwosu
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Clinical Manifestations ◽  
Severe Illness ◽  
Prognostic Implication ◽  
Poor Prognostic Factor ◽  
Medical Databases ◽  
Reactive Protein ◽  
Prognostic Implications

Coronavirus disease-2019 (COVID-19) has been declared as a pandemic affecting several millions of people worldwide. It has varied clinical manifestations ranging from asymptomatic to critical illness. It has led to the mortality of several affected individuals. However, the prognosis seems to vary from one person to the other and efforts are being made to identify the prognostic factors. Hypocalcaemia has been identified as a poor prognostic factor with a high frequency among individuals affected with COVID-19. This review aims to estimate the prevalence of hypocalcaemia among COVID-19 patients and identify the poor prognostic factors associated with the presence of hypocalcaemia in COVID-19 patients. Electronic medical databases were searched for publications on the prognostic implications of hypocalcaemia in COVID-19 infection, and relevant articles were selected for systematic review following PRISMA algorithm. The prevalence of hypocalcaemia among patients with COVID-19 was 40.0-74.4%. There was a significant association between the rate of hospital admission, intensive care unit (ICU) admission as well as septic shock and hypocalcaemia in patients with COVID-19. Hypocalcaemia is also associated with a higher mortality rate in these patients. COVID-19 patients with hypocalcaemia tend to have elevated C-reactive protein, interleukin6, alanine transaminase, procalcitonin, serum creatinine and low albumin.   Hypocalcaemia is common in COVID-19 patients and is a poor prognostic factor in these patients. Presence of hypocalcaemia is  associated with a severe illness and even death. Keywords: COVID-19; hypocalcaemia; prognosis; systematic review

scholarly journals Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051554
Author(s):  
Pascal Richard David Clephas ◽  
Sanne Elisabeth Hoeks ◽  
Marialena Trivella ◽  
Christian S Guay ◽  
Preet Mohinder Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Meta Analysis ◽  
Case Series ◽  
Related Factors ◽  
Surgical Pain ◽  
Literature Reviews ◽  
Chronic Post Surgical Pain

IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.

scholarly journals Prognostic factors for acute exacerbation of idiopathic pulmonary fibrosis: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028226
Author(s):  
Hiroyuki Kamiya ◽  
Ogee Mer Panlaqui
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Acute Exacerbation ◽  
Case Reports ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Grade Method

IntroductionIdiopathic pulmonary fibrosis (IPF) is a form of chronic fibrosing interstitial pneumonia with unknown disease aetiology. Acute exacerbation (AE) of IPF is an accelerated disease progression beyond its expected course. A 30-day mortality of AE of IPF is 40%. While death may occur, there is much variation in the clinical progression of this condition. Previous attempts have been made to investigate various possible prognostic factors for AE of IPF; however, they have yet to be confirmed. The aim of this systematic review is to clarify these prognostic factors.Methods and analysisIn this review, AE of IPF is the condition of interest, which has been defined according to previously established diagnostic criteria. The primary outcomes of interest include short-term all-cause mortality and pulmonary-cause mortality. The secondary outcomes of interest include long-term mortality and hospital separation for the disease. Primary studies investigating prognostic factors for AE of IPF are eligible for inclusion in this review. All study types are permitted except case reports. Two reviewers will search electronic databases, such as Medline and EMBASE, from 2002 to the 1 April 2019 and extract data independently. Risk of bias in individual studies will be assessed using the Quality in Prognostic Studies tool. Meta-analysis will be conducted for univariate data if at least three studies report the effect of a specific prognostic factor using similar statistical methods. Multivariate results will be reported qualitatively. Subgroup analysis and sensitivity analysis will be considered with the aim of generalising findings to the clinical settings and drawing more robust conclusions. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) method will be applied to evaluate the quality of evidence for each prognostic factor.Ethics and disseminationEthical approval will not be required. Results will be reported in a peer-reviewed scientific journal.PROSPERO registration numberCRD42018106172

A pooled analysis of 1,546 patients with AIDS-related lymphoma (ARL): An assessment of prognostic factors by treatment era.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8524-8524
Author(s):  
Stefan K. Barta ◽  
Michael Samuel ◽  
Xiaonan Xue ◽  
Jeanette Y. Lee ◽  
Nicolas Mounier ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Prognostic Significance ◽  
Pooled Analysis ◽  
Cd4 Count ◽  
Significant Prognostic Factor ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Time Period ◽  
Increased Risk

8524 Background: Management of ARL evolved in the last 2 decades. We previously reported prognostic factors in a pooled analysis of 1,546 patients with ARL, and here present analysis of these factors over time to determine if their prognostic significance has changed. Methods: Following a systematic review, we assembled individual patient data from 19 prospective phase 2/3 clinical trials (published 1993-2010) for ARL (n=1,546). Factors analyzed include age, sex, histology, CD4 count, prior history of (h/o) AIDS, & age-adjusted (aa) IPI. The endpoint was overall survival (OS) expressed as the hazard ratio (HR) for death. We used separate Cox proportional hazard models adjusted for the other covariates to determine the significance of each variable in the following time periods: pre-cART [combination antiretroviral therapy] (<1996; n=388), early cART (‘96-‘00; n=694), modern cART (‘01-‘04; n=282) & current era (‘05-‘10; n=182). We also combined all enrollments in one Cox model to test for difference in association with OS over enrollment periods. Results: Rituximab use was limited in the early cART (20%) compared with the modern cART (83%) and current (93%) eras. Histology & sex were not significantly associated with OS in any time period. Increasing age was associated with worse OS in the pre-cART (HR 1.02; p<0.01) and current (HR 1.05, p=0.04) eras. A prior h/o AIDS increased risk of death during early cART (HR 1.31, p=0.047) but was not significant after 2000. Meanwhile, baseline CD4 count <50 was a poor prognostic factor during early (HR 1.78, p<0.01) and modern cART (HR 2.76, p=0.001) eras, but not in the current era. The aaIPI predicted worse OS in each time period (pre-cART: HR 1.54, p<0.0001; early cART: HR 1.49, p<0.0001; modern cART: HR 1.52, p<0.01; current era: HR 2.34, p<0.0001). No significant interaction between each prognostic factor with enrollment was found. Conclusions: In this pooled analysis of 1,546 patients with ARL, aaIPI was the only consistently significant prognostic factor and its effect was magnified in the current era. HIV-related factors gained prognostic relevance in the early and modern cART era but may not be as relevant with current treatment strategies.

scholarly journals Predictors of Post-Thrombotic Syndrome (PTS) in Pediatric Thrombosis: A Systematic Review and Meta-Analysis of the Literature

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3806-3806 ◽  
Author(s):  
Elissa Engel ◽  
Manuela Albisetti ◽  
Leonardo R. Brandao ◽  
Ernest Amankwah ◽  
Anthony Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Factors Associated ◽  
Post Thrombotic Syndrome ◽  
Statistical Heterogeneity

Abstract BACKGROUND: Post-thrombotic syndrome (PTS) is the most common long-term complication in pediatric deep venous thrombosis (DVT), affecting approximately 25% of children with an extremity DVT. PTS leads to a high physical, psychological and financial burden in affected patients. Although several risk factors have been associated with the development of pediatric PTS, few of them have been validated in the pediatric literature. A better understanding of the prognostic factors leading to PTS is a vital step for early identification of those children at greatest risk in order to develop risk-stratified interventions aimed at preventing this complication. AIM: To perform a systematic review and meta-analysis of available published evidence from the pediatric literature on prognostic factors for pediatric PTS. METHODS: A systematic search of MEDLINE, EMBASE, and the Cochrane Library from 1960 to December 2017 was performed. MeSH terms and search strategy employed were as follows: "postthrombotic syndrome" OR "postphlebitic syndrome" AND "all child 0-18 years" AND "young adult 19-24 years". A study was eligible for inclusion if it evaluated the development of PTS in pediatric patients (<21 years of age) with a confirmed extremity DVT and reported on at least one prognostic factor for the development of PTS. Single case reports, narrative reviews, and commentaries were excluded. Studies assessing the efficacy/safety of thrombolysis, and studies including patients >21 years of age with outcomes not reported by age group, were also excluded. Two reviewers independently screened all studies and extracted the data of interest. Data were analyzed using STATA v.15 statistical software. Meta-analyses were conducted for risk factors reported in at least three studies. Summary odds ratios (ORs) and 95% confidence intervals (CI) were calculated from the effect estimates from the individual studies using a random effects model. Statistical heterogeneity was quantified by I2 statistic. RESULTS: A total of 12 studies met the final inclusion criteria (Figure 1), nine cohort studies, two cross-sectional studies, and one case-control study. These studies reported a total of 1,160 patients with venous thromboembolism (VTE), of whom 938 (81%) were assessed for PTS (Table 1). Median age across studies ranged from 0.02 - 15.5 years. VTE was considered provoked in nearly 80% of patients. The most common reported risk factor for VTE was the presence of a central venous catheter (CVC, 54%) followed by congenital heart disease (26%). PTS was diagnosed in 46% (n=434) of patients with an extremity DVT. The median time from DVT diagnosis to PTS diagnosis ranged from 12 to 33 months across studies. Among studies reporting this information, mild PTS was most frequently diagnosed, followed by moderate and severe PTS (35%, 5% and 0.6% of patients respectively). Most common prognostic factors associated with PTS in individual studies included patient characteristics: age and gender; and DVT characteristics: recurrent DVT, symptomatic DVT, DVT degree of occlusion, and time between DVT diagnosis and PTS assessment. Three studies investigated the association of elevated factor VIII and d-dimer levels with PTS. Elevated levels of these biomarkers were found to be associated with development of adverse VTE outcomes in one study but this finding was not confirmed in the other studies. Meta-analysis of reported prognostic factors identified the presence of a CVC and occlusive DVT as significant risk factors for the development of pediatric PTS (OR= 1.8, 95%CI=1.08-2.98, and OR=1.89, 95%CI=1.04-3.46 respectively; Figure 2). CONCLUSION: Among 12 studies evaluating prognostic factors for PTS in children and meeting criteria for this meta-analysis, CVC-related DVT and complete occlusion were associated with pediatric PTS. Overall, high-quality evidence on pediatric PTS is lacking. Collaborative prospective cohort studies and trials that use validated pediatric PTS measures and standardized prognostic factor definitions are needed to better understand the risk factors associated with PTS. Disclosures No relevant conflicts of interest to declare.

Is young age a poor prognostic factor in triple-negative breast cancer patients? Analysis of 363 patients from single institution registry.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12023-e12023
Author(s):  
Mohamed Salah Fayaz ◽  
Gerges Attia Demian ◽  
Mustafa El-Sherify ◽  
Sadeq Abuzalouf ◽  
Thomas George ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Young Age ◽  
Lymph Node Status ◽  
Poor Prognostic Factor ◽  
Free Survival

e12023 Background: Young age is a known independent poor prognostic factor for breast cancer. Few data exist about validating such prognostic factor in triple negative subtype of breast cancer. In this study, we evaluate the prognostic value of young age presentation in triple negative breast cancer (TNBC) patients who were diagnosed in Kuwait Cancer Control Center. Methods: This is a retrospective analysis of 363 patients diagnosed with TNBC between July 1999 and June 2009. Of these, 27% were diagnosed at or below the age of 40. Chi-square test was used to correlate the age with other prognostic factors. Survival measurements were estimated using Kaplan-Meier analysis. Statistical significance was calculated using the log-rank test. Results: There was no correlation between young age at presentation and other prognostic factors including grade, T stage, lymph node status, lymphovascular invasion, and Ki67 positivity. Similarly, young age was not statistically associated with poorer 5-years overall survival (78% for patients < 40 years compared to 72% for those > 40 years; p = 0.13), disease free survival (66% vs. 61%; p = 0.5) or locoregional recurrence free survival (81% vs. 83%; p = 0.7). Conclusions: Young age does not seem to negatively impact the survival of TNBC patients nor associated with poor prognostic factors in our study population. Further studies are needed to define new prognostic factors, e.g. molecular markers, in this subtype of patients rather than the conventional clinicopathologic prognostic factors.

scholarly journals The clinicopathological features and prognostic value of lymphovascular invasion in patients with upper tract urinary carcinoma after radical nephroureterectomy:  an updated systematic review and meta-analysis.

2019 ◽  
Author(s):  
Lijin Zhang ◽  
Bin Wu ◽  
Zhenlei Zha ◽  
Hu Zhao ◽  
Jun Yuan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factor ◽  
Prognostic Value ◽  
Lymphovascular Invasion ◽  
Meta Analysis ◽  
Clinicopathological Features ◽  
Current Evidence ◽  
Radical Nephroureterectomy ◽  
Poor Prognostic Factor ◽  
Upper Tract

Abstract Background and Purpose: Although the prognostic value of lymphovascular invasion (LVI) for upper tract urinary carcinoma (UTUC) have been described. There is lack of consensus regarding the prognostic factor of LVI in UTUC. The aim of present study was to evaluate the current evidence regarding the contemporary role of LVI through systematic review and meta-analysis according to the updated literatures. Materials and Methods: In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE was performed for all reports published until July 2019 that included detailed results on the predictors of LVI. Results: Our meta-analysis included thirty one eligible studies containing 14,653 UTUC patients (81-1,363 per study). According to our final results, there was a significant correlation of LVI with worse cancer-specific survival (CSS) (HR=1.62, 95 % CI: 1.49-1.76, p < 0.001), overall survival (OS) (HR=1.55, 95 % CI: 1.41-1.71, p < 0.001), recurrence-free survival (RFS) (HR=1.46, 95 % CI: 1.32-1.61, p < 0.001), cancer-specific mortality (CSM) (HR=1.25, 95 % CI: 1.00-1.56, p = 0.047) and recurrence(HR=1.23, 95 % CI: 1.03-1.48, p = 0.026). In addition, LVI was also correlated with advanced TNM stage (III/IV vs. I/II: OR = 7.63, 95% CI: 5.60–10.39, p < 0.001), higher tumor grade (3 vs. 1/2: OR = 5.61, 95% CI: 3.71–8.48, p < 0.001), lymph node metastasis (yes vs. no: OR = 4.95, 95% CI: 3.66–6.71, p < 0.001), carcinoma in situ (yes vs. no: OR = 1.92, 95% CI: 1.36–2.70, p < 0.001) and positive surgical margin (yes vs. no: OR = 4.38, 95% CI: 2.71–7.07, p < 0.001), but not related to gender (male vs. female: OR = 0.98, 95% CI: 0.80–1.19, p = 0.825) and multifocality (multifocal vs. unifocal: OR = 1.10, 95% CI: 0.82–1.47, p = 0.539). The funnel plot test indicated that no significant publication bias in the meta-analysis. Conclusions: This study demonstrated that LVI was associated with more aggressive clinicopathological features and could serve as a poor prognostic factor for patient with UTUC after radical nephroureterectomy.

scholarly journals Prognostic factors in pontine haemorrhage: A systematic review

2018 ◽  
Vol 3 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Réza Behrouz
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Surgical Outcome ◽  
English Language ◽  
Intraventricular Haemorrhage ◽  
Outcome Studies ◽  
Level Of Consciousness ◽  
All Cause Mortality ◽  
Pontine Haemorrhage

Background Pontine haemorrhage comprises approximately 10% of intracerebral haemorrhages. There is a common presumption that pontine haemorrhage is inherently associated with poor outcome. Purpose The aim of the review was to identify chief predictors of prognosis in (pontine haemorrhage) through systematic review of published literature. Methods A query of PubMed/MEDLINE was conducted in search of studies in English language since, 1980 focusing specifically on outcome in pontine haemorrhage. References for each publication were reviewed for additional studies not detected by the PubMed/MEDLINE probe. Surgical outcome studies were excluded from the review. Findings The query identified 7867 titles, after removal of duplicates and irrelevant studies, 20 titles were included in the review. In a total of 1437 pontine haemorrhage patients included in the 20 studies, the overall rate for early all-cause mortality was 48.1%. Level of consciousness on admission and haemorrhage size were the most consistent predictors of mortality in patients with pontine haemorrhage. Haemorrhage localisation within the pons was also a prognostic factor, but not consistently. Age and intraventricular extension were not found to be powerful prognostic predictors. Discussion/Conclusion Based on this review, level of consciousness on admission and haemorrhage size were the most influential prognostic factors in pontine haemorrhage, whereas age, haemorrhage localisation, and intraventricular haemorrhage did not consistently predict prognosis.

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