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Intensive Care Medicine Apr 2024The aim of this study is to provide a summary of the existing literature on the association between hypotension during intensive care unit (ICU) stay and mortality and... (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this study is to provide a summary of the existing literature on the association between hypotension during intensive care unit (ICU) stay and mortality and morbidity, and to assess whether there is an exposure-severity relationship between hypotension exposure and patient outcomes.
METHODS
CENTRAL, Embase, and PubMed were searched up to October 2022 for articles that reported an association between hypotension during ICU stay and at least one of the 11 predefined outcomes. Two independent reviewers extracted the data and assessed the risk of bias. Results were gathered in a summary table and studies designed to investigate the hypotension-outcome relationship were included in the meta-analyses.
RESULTS
A total of 122 studies (176,329 patients) were included, with the number of studies varying per outcome between 0 and 82. The majority of articles reported associations in favor of 'no hypotension' for the outcomes mortality and acute kidney injury (AKI), and the strength of the association was related to the severity of hypotension in the majority of studies. Using meta-analysis, a significant association was found between hypotension and mortality (odds ratio: 1.45; 95% confidence interval (CI) 1.12-1.88; based on 13 studies and 34,829 patients), but not for AKI.
CONCLUSION
Exposure to hypotension during ICU stay was associated with increased mortality and AKI in the majority of included studies, and associations for both outcomes increased with increasing hypotension severity. The meta-analysis reinforced the descriptive findings regarding mortality but did not yield similar support for AKI.
Topics: Humans; Critical Care; Morbidity; Hospital Mortality; Hypotension; Acute Kidney Injury; Intensive Care Units
PubMed: 38252288
DOI: 10.1007/s00134-023-07304-4 -
BMC Medical Research Methodology Jul 2004Reducing maternal mortality and morbidity are among the key international development goals. A prerequisite for monitoring the progress towards attainment of these goals... (Comparative Study)
Comparative Study Review
BACKGROUND
Reducing maternal mortality and morbidity are among the key international development goals. A prerequisite for monitoring the progress towards attainment of these goals is accurate assessment of the levels of mortality and morbidity. In order to contribute to mapping the global burden of reproductive ill-health, we are conducting a systematic review of incidence and prevalence of maternal mortality and morbidity.
METHODS
We followed the standard methodology for systematic reviews. We prepared a protocol and a form for data extraction that identify key characteristics on study and reporting quality. An extensive search was conducted for the years 1997-2002 including electronic and hand searching.
RESULTS
We screened the titles and abstracts of about 65,000 citations identified through 11 electronic databases as well as various other sources. Four thousand six hundred and twenty-six full-text reports were critically appraised and 2443 are included in the review so far. Approximately one third of the studies were conducted in Asia and Africa. The reporting quality was generally low with definitions for conditions and the diagnostic methods often not reported.
CONCLUSIONS
There are unique challenges and issues regarding the search, critical appraisal and summarizing epidemiological data in this systematic review of prevalence/incidence studies. More methodological studies and discussion to advance the field will be useful. Considerable efforts including leadership, consensus building and resources are required to improve the standards of monitoring burden of disease.
Topics: Adult; Cohort Studies; Cross-Sectional Studies; Female; Global Health; Humans; Incidence; Maternal Mortality; Pregnancy; Pregnancy Complications; Prevalence; World Health Organization
PubMed: 15236664
DOI: 10.1186/1471-2288-4-16 -
NPJ Primary Care Respiratory Medicine Oct 2022Sleep-disordered breathing (SDB) is characterized by repeated breathing pauses during sleep. The prevalence of SDB varies widely between studies. Some longitudinal... (Review)
Review
Sleep-disordered breathing (SDB) is characterized by repeated breathing pauses during sleep. The prevalence of SDB varies widely between studies. Some longitudinal studies have found an association of SDB with incident or recurrent cardiovascular events. We sought to systematically describe the current data on the correlation between SDB and cardiovascular pathology. Studies were included if they were original observational population-based studies in adults with clearly diagnosed SDB. The primary outcomes include all types of cardiovascular pathology. We carried out pooled analyses using a random effects model. Our systematic review was performed according to the PRISMA and MOOSE guidelines for systematic reviews and was registered with PROSPERO. In total, 2652 articles were detected in the databases, of which 76 articles were chosen for full-text review. Fourteen studies were focused on samples of an unselected population, and 8 studies were focused on a group of persons at risk for SDB. In 5 studies, the incidence of cardiovascular pathology in the population with SDB was examined. In total, 49 studies described SDB in patients with cardiovascular pathology. We found an association between SDB and prevalent /incident cardiovascular disease (pooled OR 1.76; 95% CI 1.38-2.26), and pooled HR (95% CI 1.78; 95% CI 1.34-2.45). Notably, in patients with existing SDB, the risk of new adverse cardiovascular events was high. However, the relationship between cardiovascular disease and SDB is likely to be bidirectional. Thus, more large-scale studies are needed to better understand this association and to decide whether screening for possible SDB in cardiovascular patients is reasonable and clinically significant.
Topics: Cardiovascular Diseases; Humans; Incidence; Prevalence; Sleep Apnea Syndromes
PubMed: 36253378
DOI: 10.1038/s41533-022-00307-6 -
PLoS Medicine Sep 2019Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help...
BACKGROUND
Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems.
METHODS AND FINDINGS
The ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although 25 countries representing all global regions (Africa, the Americas, Southeast Asia, the Western Pacific, Europe, and the Eastern Mediterranean) were reflected, there were limited countries from the Eastern Mediterranean and Europe regions. Twenty-four articles reported policy effects on birth and/or death registration. Twenty-one of the 24 articles found that the change in registration rate after the policy was positive, with two supply and one penalty articles being the exceptions. The qualitative syntheses identified 15 operational considerations across all policy categories. Human and financial resource requirements were not quantified. The primary limitation of this systematic review was the threat of publication bias wherein many countries may not have documented their experience; this threat is most concerning for policies that had neutral or negative effects.
CONCLUSIONS
Our systematic review suggests that combination policy approaches, consisting of at least a supply and demand component, were consistently associated with improved registration rates in different geographical contexts. Operational considerations should be interpreted based on health system, governance, and sociocultural context. More evaluations and research are needed from the Eastern Mediterranean and Europe regions. Further research and evaluation are also needed to estimate the human and financial resource requirements required for different policies.
Topics: Data Accuracy; Data Collection; Human Rights; Humans; Policy Making; Population Surveillance; Public Health; Registries; Vital Statistics
PubMed: 31560684
DOI: 10.1371/journal.pmed.1002929 -
International Journal of Surgery... Apr 2020Cardiac tumors and their associated outcomes are poorly characterized. This study sought to comprehensively assess the epidemiology and natural history of primary and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Cardiac tumors and their associated outcomes are poorly characterized. This study sought to comprehensively assess the epidemiology and natural history of primary and secondary malignant cardiac tumors (PMCT and SMCT), a well as establish predictors of mortality.
METHODS
A comprehensive literature review was performed to identify articles reporting on PMCTs and SMCTs. The prevalence of important cardiac tumor (CT) subtypes was evaluated and further stratified based on the continental region. Outcomes of interest included short- and long-term mortality and utilization of heart transplantation (HTX). A random effect model was adopted, and a meta-regression was performed to determine predictors of the prevalence of CTs as well as predictors of operative mortality.
RESULTS
Of the 1,226 retrieved articles, 74 were included in our study (n = 8,849 patients). The mean follow-up was 2.27 years, mean age was 42.9 years, and 55% of the patients were females. There was a total number of 7,484 benign primary cardiac tumors (PCTs) (5,140 were myxoma), 862 (9.7%) malignant PCTs, and 355 secondary cardiac tumors. The prevalence of PMCTs among PCTs was 10.83% [95%CI = 09.11; 12.83%] with a trend towards being lower in South America compared to other continents (Prevalence = 5.80%). The prevalence of HTX among all patients was 2.45% [1.36; 4.38%]. The pooled short-term mortality was 5.90% [4.70; 7.39%] and the incidence of late mortality in all CTs, benign CT and PMCTs was 2.55% [1.76; 3.72%], 0.79% [0.46; 1.37%] and 14.77% [9.32; 23.40%], respectively. On meta-regression, the annual volume of cardiac tumor cases per center was the only predictor of lower early mortality (Beta = -0.14 ± 0.03, P < 0.0001).
CONCLUSIONS
PMCTs represent the minority of PCT (~10%) and have a higher prevalence in Europe and North America. Survival is higher in benign pathology and is significantly improved by treatment in specialized high-volume centers. Approximately 2% of patients with CTs undergo heart transplantation.
Topics: Adult; Europe; Female; Heart Neoplasms; Humans; Incidence; Male; North America; Prevalence; Time Factors
PubMed: 32169566
DOI: 10.1016/j.ijsu.2020.02.039 -
Eye (London, England) Sep 2016Childhood cataract is an avoidable cause of visual disability worldwide and is a priority for VISION 2020: The Right to Sight. There is a paucity of information about... (Review)
Review
Childhood cataract is an avoidable cause of visual disability worldwide and is a priority for VISION 2020: The Right to Sight. There is a paucity of information about the burden of cataract in children and the aim of this review is to assess the global prevalence of childhood cataract. The methodology for the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a literature search for studies reporting estimates of prevalence or incidence of cataract among children (aged<18 years) at any global location using the Cochrane Library, Medline and Embase up to January 2015. No restrictions were imposed based on language or year of publication. Study quality was assessed using a critical appraisal tool designed for systematic reviews of prevalence. Twenty prevalence and four incidence studies of childhood cataract from five different geographical regions were included. The overall prevalence of childhood cataract and congenital cataract was in the range from 0.32 to 22.9/10000 children (median=1.03) and 0.63 to 9.74/10000 (median=1.71), respectively. The incidence ranged from 1.8 to 3.6/10000 per year. The prevalence of childhood cataract in low-income economies was found to be 0.42 to 2.05 compared with 0.63 to 13.6/10000 in high-income economies. There was no difference in the prevalence based on laterality or gender. This review highlights substantial gaps in the epidemiological knowledge of childhood cataract worldwide, particularly from low and lower middle-income economies. More studies are needed using standard definitions and case ascertainment methods with large enough sample sizes.
Topics: Adolescent; Cataract; Cataract Extraction; Child; Child, Preschool; Databases, Factual; Global Health; Humans; Incidence; Infant; Infant, Newborn; Prevalence
PubMed: 27518543
DOI: 10.1038/eye.2016.156 -
Seminars in Arthritis and Rheumatism Oct 2020Giant cell arteritis (GCA; sometimes referred to as temporal arteritis) and polymyalgia rheumatica (PMR) are common and interrelated inflammatory conditions that almost... (Review)
Review
BACKGROUND
Giant cell arteritis (GCA; sometimes referred to as temporal arteritis) and polymyalgia rheumatica (PMR) are common and interrelated inflammatory conditions that almost exclusively affect adults older than 50 years. There is a need for updated information on the epidemiology of these diseases.
OBJECTIVE
This systematic literature review (SLR) aims to summarize current evidence regarding the global incidence and prevalence of GCA and PMR.
METHODOLOGY
A systematic search of PubMed and Google Scholar databases from their inception dates to July 30, 2019 for relevant publications was performed. Studies that reported incidence and/or prevalence estimates for GCA and/or PMR were identified. When there were multiple studies of the same population, the most recent estimates were used. Details on source populations and case validation were systematically reviewed. Results were tabulated per region in the world.
RESULTS
Screening by 2 authors resulted in 2643 abstracts, of which 77 articles met the inclusion criteria. There were more studies on GCA compared to PMR, and more on incidence than on prevalence. Wide variations were found in study design and populations studied. Studies that included a thorough case validation tended to give lower estimates, in particular for PMR. The highest incidence per 100 000 aged ≥50 years of GCA was observed in studies from Scandinavia and the UK (14.6 to 43.6), and in Minnesota, USA (19.8 per 100 000). Corresponding estimates for Southern Europe were lower (1.1 to 11.1). Limited evidence indicates that GCA and PMR is less common in non-Caucasian populations. Prevalence estimates for PMR were ≥ 3 times higher than that of GCA in Caucasians.
CONCLUSION
This SLR provides up to date estimates of the occurrence of GCA and PMR in different populations around the world. The incidence of GCA is higher in populations of Northern European ancestry. Data on the epidemiology of PMR are more limited, with greater variation in incidence and prevalence estimates.
Topics: Databases, Factual; Giant Cell Arteritis; Humans; Incidence; Polymyalgia Rheumatica; Prevalence
PubMed: 32911281
DOI: 10.1016/j.semarthrit.2020.07.005 -
BioMed Research International 2020Uveitis is a known ophthalmologic manifestation of seronegative spondyloarthropathy, including psoriatic arthritis. However, the data is less clear among patients with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Uveitis is a known ophthalmologic manifestation of seronegative spondyloarthropathy, including psoriatic arthritis. However, the data is less clear among patients with psoriasis due to the limited number of published studies.
AIMS
To investigate whether the risk of incident and prevalent uveitis is elevated among patients with psoriasis using systematic review and meta-analysis technique.
METHODS
The MEDLINE and EMBASE databases were searched from their inception to May 2019. Eligible studies must have included a psoriasis group and a nonpsoriasis group. Eligible studies must also have investigated for prevalent or incident uveitis, and the magnitude of difference between the study groups must have been reported. Pooled risk ratio and 95% confidence interval (CI) were calculated using random-effect generic inverse variance methods.
RESULTS
Of 7,107 potentially eligible articles from the EMBASE and MEDLINE databases, 7 studies were included in the meta-analysis. Two of those studies compared the incidence, and 5 studies compared the prevalence of uveitis between the psoriasis and nonpsoriasis groups. For incident uveitis, a total of 5,865,801 patients (222,083 with psoriasis and 5,643,718 without psoriasis) were analyzed. For prevalent uveitis, a total of 1,343,436 patients (37,891 with psoriasis and 1,305,545 without psoriasis) were studied. The risk of incident uveitis was significantly higher among patients with psoriasis with a pooled risk ratio of 1.23 (95% CI: 1.05-1.45, = 55%). The risk of prevalent uveitis was also significantly higher among patients with psoriasis with a pooled risk ratio of 1.97 (95% CI: 1.68-2.31, = 0%).
CONCLUSIONS
The results of this study revealed significantly increased risk of both prevalent and incident uveitis among patients with psoriasis.
Topics: Arthritis, Psoriatic; Humans; Incidence; Prevalence; Psoriasis; Risk Factors; Uveitis
PubMed: 32724820
DOI: 10.1155/2020/9308341 -
BMC Public Health Jul 2013All-cause mortality in the population<65 years is 30% higher in Glasgow than in equally deprived Liverpool and Manchester. We investigated a hypothesis that low vitamin... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
All-cause mortality in the population<65 years is 30% higher in Glasgow than in equally deprived Liverpool and Manchester. We investigated a hypothesis that low vitamin D in this population may be associated with premature mortality via a systematic review and meta-analysis.
METHODS
Medline, EMBASE, Web of Science, the Cochrane Library and grey literature sources were searched until February 2012 for relevant studies. Summary statistics were combined in an age-stratified meta-analysis.
RESULTS
Nine studies were included in the meta-analysis, representing 24,297 participants, 5,324 of whom died during follow-up. The pooled hazard ratio for low compared to high vitamin D demonstrated a significant inverse association (HR 1.19, 95% CI 1.12-1.27) between vitamin D levels and all-cause mortality after adjustment for available confounders. In an age-stratified meta-analysis, the hazard ratio for older participants was 1.25 (95% CI 1.14-1.36) and for younger participants 1.12 (95% CI 1.01-1.24).
CONCLUSIONS
Low vitamin D status is inversely associated with all-cause mortality but the risk is higher amongst older individuals and the relationship is prone to residual confounding. Further studies investigating the association between vitamin D deficiency and all-cause mortality in younger adults with adjustment for all important confounders (or using randomised trials of supplementation) are required to clarify this relationship.
Topics: Adult; Aged; Female; Humans; Incidence; Male; Middle Aged; Mortality, Premature; United Kingdom; Vitamin D Deficiency
PubMed: 23883271
DOI: 10.1186/1471-2458-13-679 -
International Journal of Environmental... Jan 2021The present study aimed to quantify the relationship between body dissatisfaction and morbid exercise behaviour (MEB). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The present study aimed to quantify the relationship between body dissatisfaction and morbid exercise behaviour (MEB).
METHODS
The electronic databases MEDLINE, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global were searched from inception to September 2020. Pooled effect sizes corrected for sampling errors () were computed using a bare-bones meta-analysis. The robustness of the results was examined by influence analyses. The presence of moderators was examined by inspection of the variance in attributable to sampling errors and 80% credibility intervals, followed by subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined by visual inspection of funnel plot symmetry, cumulative meta-analysis, and Egger's test.
RESULTS
A total of 41 effect sizes from 33 studies ( = 8747) were retrieved. Results showed a significant and near to moderate effect size ( = 0.267, 95% CI = 0.226 to 0.307), and this did not differ by gender, BMI, age, percentage of Whites, study quality, or MEB measure. Conversely, effect sizes were found to be stronger in published and more recently conducted studies.
CONCLUSION
The findings indicate that body dissatisfaction is one of the likely causes underlying MEB. This suggests the need for further longitudinal research aimed at confirming the potential causal nature of this relationship.
Topics: Body Dissatisfaction; Exercise; Morbidity
PubMed: 33445591
DOI: 10.3390/ijerph18020585