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Psychiatry Research Nov 2023Suicide is a multifaceted event precipitated by underlying biopsychosocial risk factors. Evidence for various psychiatric morbidities underlying suicidality through... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Suicide is a multifaceted event precipitated by underlying biopsychosocial risk factors. Evidence for various psychiatric morbidities underlying suicidality through Psychological Autopsy (PA) is established in case-control studies. However, considering the possible geographical variations and the limited number of studies from developing countries, the estimates of such risk factors across the world could provide great insight into their comparative prevalence and assist in targeting the prevention of suicide.
METHODS
A systematic review of the literature from 1991 to 2020 in the English language was conducted with the protocol registration on PROSPERO ID (CRD 42021249216) to identify the pooled odds ratio of any psychiatric morbidity as a risk factor for suicide.
RESULTS
Out of 1144 articles, 43 studies were included in this review. The pooled odds ratio for any psychiatric morbidity measured across 31 studies was 16.71 (95% CI: 12.29 - 22.70, Tau = 0.58, I = 80.4%, Cochran's Q = 153.36, df = 30, p-value <0.001). The subgroup analysis for affective disorder, previous suicide attempt, WHO region-wise risk distribution, and publication year of study were not significant.
CONCLUSIONS
There is a sixteen-fold increased risk of suicide in persons with mental disorders compared to healthy controls, and the risk is similar across the geographical region and publication time. The international efforts to reduce the common risk factors for suicide would equally be helpful for all countries despite cultural variations. Early identification and treatment of sleep disorders, physical illnesses, anxiety, and personality disorders should be prioritized along with the established mental disorders to reduce suicide rates across the world.
Topics: Humans; Prevalence; Autopsy; Mental Disorders; Suicide, Attempted; Case-Control Studies
PubMed: 37783094
DOI: 10.1016/j.psychres.2023.115492 -
Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis.BJS Open Nov 2023Postoperative complications occur in up to 43% of patients after surgery, resulting in increased morbidity and economic burden. Prehabilitation has the potential to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Postoperative complications occur in up to 43% of patients after surgery, resulting in increased morbidity and economic burden. Prehabilitation has the potential to increase patients' preoperative health status and thereby improve postoperative outcomes. However, reported results of prehabilitation are contradictory. The objective of this systematic review is to evaluate the effects of prehabilitation on postoperative outcomes (postoperative complications, hospital length of stay, pain at postoperative day 1) in patients undergoing elective surgery.
METHODS
The authors performed a systematic review and meta-analysis of RCTs published between January 2006 and June 2023 comparing prehabilitation programmes lasting ≥14 days to 'standard of care' (SOC) and reporting postoperative complications according to the Clavien-Dindo classification. Database searches were conducted in PubMed, CINAHL, EMBASE, PsycINFO. The primary outcome examined was the effect of uni- or multimodal prehabilitation on 30-day complications. Secondary outcomes were length of ICU and hospital stay (LOS) and reported pain scores.
RESULTS
Twenty-five studies (including 2090 patients randomized in a 1:1 ratio) met the inclusion criteria. Average methodological study quality was moderate. There was no difference between prehabilitation and SOC groups in regard to occurrence of postoperative complications (OR = 1.02, 95% c.i. 0.93 to 1.13; P = 0.10; I2 = 34%), total hospital LOS (-0.13 days; 95% c.i. -0.56 to 0.28; P = 0.53; I2 = 21%) or reported postoperative pain. The ICU LOS was significantly shorter in the prehabilitation group (-0.57 days; 95% c.i. -1.10 to -0.04; P = 0.03; I2 = 46%). Separate comparison of uni- and multimodal prehabilitation showed no difference for either intervention.
CONCLUSION
Prehabilitation reduces ICU LOS compared with SOC in elective surgery patients but has no effect on overall complication rates or total LOS, regardless of modality. Prehabilitation programs need standardization and specific targeting of those patients most likely to benefit.
Topics: Humans; Preoperative Exercise; Databases, Factual; Morbidity; Pain, Postoperative; Postoperative Complications; Randomized Controlled Trials as Topic
PubMed: 38108466
DOI: 10.1093/bjsopen/zrad129 -
Aging Clinical and Experimental Research Dec 2023To provide a summary of the available evidence concerning prevalence and risk factors of frailty in elderly patients with CHF. (Meta-Analysis)
Meta-Analysis
AIM
To provide a summary of the available evidence concerning prevalence and risk factors of frailty in elderly patients with CHF.
METHODS
PubMed, Embase, Web of Science, CINAHL, The Cochrane Library, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database (VIP), and Wanfang database were searched from inception to July 2023. This study strictly followed the PRISMA guidelines. The quality of the included studies was rated by the Agency for Healthcare and Research and Quality and the Newcastle-Ottawa Scale.
RESULTS
A total of 21 original studies were included, involving 4,797 patients. Meta-analysis results showed that the prevalence of frailty in older patients with heart failure was 38% (95%CI: 0.32-0.44). Age, cardiac function grading, left atrial diameter, left ventricular ejection fraction, hemoglobin, polypharmacy, BNP, nutritional risk, and hospitalization day are the influential factors of frailty in older patients with CHF.
CONCLUSION
The prevalence of frailty in older patients with CHF is high, and clinical medical personnel should identify and intervene early to reduce or delay the frailty in older patients with CHF as much as possible.
Topics: Aged; Humans; Chronic Disease; Frailty; Heart Failure; Prevalence; Risk Factors; Stroke Volume; Ventricular Function, Left
PubMed: 37864762
DOI: 10.1007/s40520-023-02587-5 -
Developmental Medicine and Child... Sep 2023To assess the prevalence and incidence of chronic conditions among adults with cerebral palsy (CP) and compare them to the prevalence and incidence among adults without... (Meta-Analysis)
Meta-Analysis Review
AIM
To assess the prevalence and incidence of chronic conditions among adults with cerebral palsy (CP) and compare them to the prevalence and incidence among adults without CP.
METHOD
We searched MEDLINE and Embase for studies reporting the prevalence or incidence of one or more chronic conditions among adults with CP. Two independent reviewers screened titles, abstracts, and full-text articles. Two independent reviewers extracted data relating to prevalence and incidence and appraised study quality. We performed random-effects meta-analyses to pool prevalence and incidence.
RESULTS
We identified 69 studies; 65 reported the prevalence of 53 conditions and 13 reported the incidence of 21 conditions. At least 20% of adults had the following conditions: depression (21%); anxiety (21%); mood affective disorders (23%); asthma (24%); hypertension (26%); epilepsy (28%); urinary incontinence (32%); malnutrition (38%); and scoliosis (46%). Adults with CP were more likely to have type 2 diabetes, anxiety, bipolar disorder, depression, schizophrenia, hypertension, ischaemic heart disease, stroke, cerebrovascular disease, asthma, liver disease, osteoarthritis, osteoporosis, underweight, and chronic kidney disease than adults without CP.
INTERPRETATION
These data from 18 countries, which provide an international perspective, may be used to promote awareness, identify targets for intervention, and inform the development of appropriate supports for adults with CP.
Topics: Humans; Adult; Cerebral Palsy; Prevalence; Incidence; Diabetes Mellitus, Type 2; Hypertension; Asthma; Chronic Disease
PubMed: 36807150
DOI: 10.1111/dmcn.15526 -
International Journal of Public Health 2023To systematically review the epidemiology of frailty in China, one of the world's most populous countries, and to provide insightful guidance for countries to deal with... (Meta-Analysis)
Meta-Analysis Review
To systematically review the epidemiology of frailty in China, one of the world's most populous countries, and to provide insightful guidance for countries to deal with fast population ageing. Six electronic databases were searched until November 2022. Data from cross-sectional studies with a clear definition of frailty and a mean age ≥60 years were pooled using meta-analysis. 64 studies ( = 106,826 participants) from 23 (67.6%) of China's provinces were included. The overall prevalence of frailty and prefrailty among older community dwellers was 10.1% (95% CI: 8.5%-11.7%) and 43.9% (95% CI: 40.1%-47.8%), respectively. Adults over 70 years, women, unmarried, living alone, and those with less education had higher odds of being frail. Furthermore, regional disparities in frailty were observed; people in rural areas or areas with worse economic conditions had a higher prevalence of frailty. A great variation in frailty prevalence was observed between subgroups of older adults stratified by common risk factors. The Chinese government should pay more attentions to seniors at high risk and regions with a high prevalence of frailty.
Topics: Humans; Female; Aged; Middle Aged; Cross-Sectional Studies; Frailty; Independent Living; Prevalence; Aging
PubMed: 37588041
DOI: 10.3389/ijph.2023.1605964 -
Human Vaccines & Immunotherapeutics Dec 2023The Omicron variant of SARS-CoV-2 was detected in October 2021 and exhibited high transmissibility, immune evasion, and reduced severity when compared to the earlier... (Review)
Review
The Omicron variant of SARS-CoV-2 was detected in October 2021 and exhibited high transmissibility, immune evasion, and reduced severity when compared to the earlier variants. The lesser vaccine effectiveness against Omicron and its reduced severity created vaccination hesitancy among the public. This review compiled data reporting the relative prevalence of Omicron as compared to the early variants to give an insight into the existing variants, which may shape the decisions regarding the targets of the newly developed vaccines. Complied data revealed more than 90% prevalence within the infected cohorts in some countries. The BA.1 subvariant predominated over the BA.2 during the early stages of the Omicron wave. Moreover, BA.4/BA.5 subvariants were detected in South Africa, USA and Italy between October 2021 and April 2022. It is therefore important to develop vaccines that protect against Omicron as well as the early variants, which are known to cause more severe complications.
Topics: Humans; COVID-19; Prevalence; SARS-CoV-2; Italy
PubMed: 37254497
DOI: 10.1080/21645515.2023.2212568 -
Oral Diseases Nov 2023This systematic review and meta-analysis aimed to estimate the global prevalence of gingival recession (GR) in the general population. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review and meta-analysis aimed to estimate the global prevalence of gingival recession (GR) in the general population.
MATERIALS AND METHODS
Population-based observational studies reporting the prevalence of GR and published from 1991 to 2021 were identified from five electronic databases and manual searches. Risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Studies. The pooled prevalence of GR was calculated by using a random-effect model. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to summarize the overall certainty of evidence.
RESULTS
A total of 15 studies involving 37,460 participants were included. The overall pooled prevalence was 78.16% at the minimal reported threshold values and 84.92% at ≥1 mm "cut-off" with high heterogeneity among studies. A separate analysis for the buccal GR revealed a pooled prevalence of 75.42%. The risk of bias was found to be high for 10 and low for 5 studies. The overall certainty of the evidence was assessed to be very low.
CONCLUSION
More than two-thirds of the population worldwide was found to be affected by GR. Studies with standard case definition and less heterogeneity are required to accurately estimate the prevalence of GR.
Topics: Humans; Gingival Recession; Prevalence; Cross-Sectional Studies
PubMed: 35735236
DOI: 10.1111/odi.14289 -
United European Gastroenterology Journal Feb 2024Several studies have reported large increases in the incidence of eosinophilic oesophagitis (EoE) in the last 20 years. We aimed to systematically review the incidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have reported large increases in the incidence of eosinophilic oesophagitis (EoE) in the last 20 years. We aimed to systematically review the incidence and prevalence of EoE, focused on all European countries.
METHODS
Systematic review and meta-analysis up to 31 December 2022, based on PubMed, CINAHL and extensive hand searching of reference lists. Twenty-five eligible studies were identified and included.
RESULTS
For both adults and children, the highest EoE incidence and prevalence have been reported from regional studies in Spain. EoE incidence for both adults and children was significantly lower (p < 0.001) in nationwide studies (meta-analysis = 3.64 per 100,000 person-years overall) compared with regional or centre-based studies (7.16). EoE incidence and prevalence were significantly higher (p < 0.001) in adults than children. All studies that reported on longitudinal trends in EoE incidence showed increases over time, more markedly during more recent years. Larger increases in incidence tend to refer to regional rather than nationwide studies; from Spain, Switzerland and Denmark, both for paediatric and adult age groups. Increases in EoE incidence 100,000 person-years were larger than for incidence per number of diagnostic endoscopies. The most frequently reported co-morbidities in adults were rhinitis, followed by asthma, food allergy and gastroesophageal reflux disease, and in children, erosive oesophagitis, asthma, food allergy and rhinitis.
CONCLUSIONS
The incidence of EoE has increased in Europe over the last 30 years, exceeding increases in the volume of oesophago-gastro-duodenoscopies performed. The patchy and low incidence and prevalence of EoE generally in Europe and compared with North America, may reflect a lack of clinical awareness and research focus rather than a genuinely low incidence of EoE. A co-ordinated Europe-wide study that uses standardised methodology is urgently needed to provide a comprehensive picture of EoE incidence and prevalence across Europe.
Topics: Adult; Humans; Child; Eosinophilic Esophagitis; Prevalence; Incidence; Europe; Food Hypersensitivity; Asthma; Rhinitis; Enteritis; Eosinophilia; Gastritis
PubMed: 37921701
DOI: 10.1002/ueg2.12465 -
European Geriatric Medicine Aug 2023To systematically review the prevalence and risk factors for frailty in patients with chronic obstructive pulmonary disease (COPD). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review the prevalence and risk factors for frailty in patients with chronic obstructive pulmonary disease (COPD).
METHODS
A systematic review and meta-analysis were conducted, and a search of the PubMed, Embase and Web of Science databases was carried out to collect Chinese and English studies on frailty and COPD published up to September 5, 2022.
RESULTS
A total of 38 articles were included for the quantitative analysis after the collected literature was either included or omitted based on pertinent criteria. The results indicated that the estimated overall pooled prevalence of frailty was 36% (95% confidence interval [CI] = 31-41%), and the estimated pre-frailty was 43% (95% CI = 37-49%). A higher age (odds ratio [OR] = 1.04; 95% CI = 1.01-1.06) and higher COPD assessment test (CAT) score (OR = 1.19; 95% CI = 1.12-1.27) were associated with a significantly increased likelihood of frailty in patients with COPD. However, a higher educational attainment (OR = 0.55; 95% CI = 0.43-0.69) and higher income (OR = 0.63; 95% CI = 0.45-0.88) were associated with a significantly reduced risk of frailty in patients with COPD. A total of 17 other risk factors for frailty were identified via qualitative synthesis.
CONCLUSION
The incidence of frailty in patients with COPD is high, and there are many influencing factors.
Topics: Humans; Prevalence; Frailty; Pulmonary Disease, Chronic Obstructive; Risk Factors; Incidence
PubMed: 37436687
DOI: 10.1007/s41999-023-00800-2 -
International Journal of Obesity (2005) Jan 2024Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze... (Review)
Review
INTRODUCTION
Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze the methods used in the cost-of-illness (COI) studies on obesity.
METHODS
We conducted systematic search in PubMed and Scopus from September 1, 2016, to July 22, 2022. Original COI studies estimating the economic cost of obesity and/or overweight in at least one country, published in English were included. To facilitate the comparison of estimates across countries, we converted the cost estimates of different years to 2022 purchasing power parity (PPP) values using each country's consumer price index (CPI) and PPP conversion rate.
RESULTS
Nineteen studies were included. All studies employed a prevalence-based approach using Population Attributable Fraction (PAF) methodology. About half of the included studies (53%) were conducted in high-income countries while the others (47%) were conducted in middle-income countries. The economic burden of obesity ranged between PPP 15 million in Brazil to PPP 126 billion in the USA, in the year 2022. Direct medical costs accounted for 0.7% to 17.8% of the health system expenditure. Furthermore, the total costs of obesity ranged from 0.05% to 2.42% of the country's gross domestic product (GDP). Of the seven studies that estimated both direct and indirect costs, indirect costs accounted for the largest portion of five studies. Nevertheless, a variety in methodology across studies was identified. The number of co-morbidities included in the analysis varied across studies.
CONCLUSIONS
Although there was a variety of methodologies across studies, consistent evidence indicated that the economic burden of obesity was substantial. Obesity prevention and control should be a public health priority, especially among countries with high prevalence of obesity.
Topics: Humans; Health Care Costs; Cost of Illness; Obesity; Comorbidity; Prevalence
PubMed: 37884664
DOI: 10.1038/s41366-023-01398-y