scholarly journals Predictors of Mortality for Nursing Home-Acquired Pneumonia: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Naveen Dhawan ◽  
Naushira Pandya ◽  
Michael Khalili ◽  
Manuel Bautista ◽  
Anurag Duggal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Pneumonia Severity Index ◽  
Final Analysis ◽  
Severity Index ◽  
Prognostic Indicator ◽  
Current Evidence ◽  
Reactive Protein ◽  
Weak Evidence ◽  
Combination Scheme

Background. Current risk stratification tools, primarily used for CAP, are suboptimal in predicting nursing home acquired pneumonia (NHAP) outcome and mortality. We conducted a systematic review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality.Methods. PubMed (MEDLINE), EMBASE, and CINAHL databases were searched for articles published in English between January 1978 and January 2014. The literature search elicited a total of 666 references; 580 were excluded and 20 articles met the inclusion criteria for the final analysis.Results. More studies supported the Pneumonia Severity Index (PSI) as a superior predictor of NHAP severity. Fewer studies suggested CURB-65 and SOAR (especially for the need of ICU care) as useful predictors for NHAP mortality. There is weak evidence for biomarkers like C-reactive protein and copeptin as prognostic tools.Conclusion. The evidence supports the use of PSI as the best available indicator while CURB-65 may be an alternative prognostic indicator for NHAP mortality. Overall, due to the paucity of information, biomarkers may not be as effective in this role. Larger prospective studies are needed to establish the most effective predictor(s) or combination scheme to help clinicians in decision-making related to NHAP mortality.

scholarly journals WITHDRAWN: TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?

2019 ◽  
Vol 7 (7) ◽  
pp. 360-369
Author(s):  
Fatma Tokgoz Akyil ◽  
Sumeyye Alparslan Bekir ◽  
Aylin Gungor ◽  
Kubra Akyuz ◽  
Neslihan Kose ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Conflicts Of Interest ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Empiric Antibiotic ◽  
Lactamase Inhibitor

Background A considerable percentage of empirical antibiotic treatment fails in hospitalized patients with community-acquired pneumonia (CAP). β-lactams and macrolid (BLM) combination or respiratory fluoroquinolones (FQ) are the most frequently used in these patients. The aim of the present study is to compare the treatment failure (TF) rates in BLM and FQ treatment and to analyze the predictive factors of TF. Method Hospitalized patients who were initially treated with either BLM or FQ were included retrospectively and treatment results of the two regimens were compared. Results Of the 144 patients included in the study, the mean age was 67±16 and 102 (71%) were male. Each group constituted of 72 patients. Antibiotic selection did not alter TF rates, length of stay (LOS) and 30-day mortality. Baseline higher levels of leucocytes, neutrophils to lymphocytes ratio (NLR), C-reactive protein (CRP), BUN/albumin, lactate dehydrogenase/aspartat aminotransferase (LDH/AST) levels and pneumonia severity index (PSI) scores were detected as predictors of TF. Conclusion Empirical treatments with either BLM or FQ do not correlate with TF, LOS and 30-day mortality. NLR, BUN/albumin and LDH/AST may suggest TF. These inexpensive and easily-reachable parameters have the potential as predictors of the treatment outcome in CAP.   Notices of retraction Akyil, F. T., Bekir, S. A., Gungor, A., Akyuz, K., Kose, N., Turker, H., Akyil, M., & Sevim, T. (2019). TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?. International Journal of Research -GRANTHAALAYAH, 7(7), 360-369. https://doi.org/10.29121/granthaalayah.v7.i7.2019.778 Article retracted by : EditorReason(s) for retraction : Author's conflicts of interest

scholarly journals The prognostic and risk-stratified value of neutrophil–lymphocyte count ratio in Chinese patients with community-acquired pneumonia

2017 ◽  
Vol 15 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Ting Yang ◽  
Chun Wan ◽  
Hao Wang ◽  
Jiangyue Qin ◽  
Lei Chen ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Lymphocyte Count ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Serum Levels ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Count Ratio

Community-acquired pneumonia is a common disease associated with high mortality. This retrospective study examined whether the neutrophil–lymphocyte count ratio (NLR), already widely used as an index of inflammation, can be used to predict in-hospital mortality of adults with community-acquired pneumonia. Clinical characteristics, CURB-65 and pneumonia severity index score of pneumonia severity, NLR, serum levels of C-reactive protein and procalcitonin, and in-hospital mortality were analyzed for 318 consecutive adults with community-acquired pneumonia admitted to West China Hospital between July 2012 and December 2013. The ability of NLR and other parameters to predict in-hospital mortality was assessed using receiver operating characteristic (ROC) curves. Results showed that NLR increased with increasing CURB-65 ( P < 0.05) and pneumonia severity index ( P < 0.05), and NLR correlated positively with serum levels of C-reactive protein (r = 0.239, P < 0.05) and procalcitonin (r = 0.211, P < 0.05). The median value of NLR was significantly higher among patients who died in hospital (11.96) than among those who were alive at the end of hospitalization (4.19, P < 0.05). Based on a cut-off NLR of 7.12, this index predicted in-hospital mortality with a sensitivity of 82.61% and specificity of 72.20% (area under ROC curve, 0.799). Predictive power was greater for the combination of NLR and serum levels of C-reactive protein and procalcitonin. These results suggest that NLR may be useful for predicting prognosis in Chinese adults with community-acquired pneumonia, and it may work better in combination with traditional markers.

scholarly journals Midregional Pro-A-Type Natriuretic Peptide and Carboxy-Terminal Provasopressin May Predict Prognosis in Community-Acquired Pneumonia

2007 ◽  
Vol 53 (12) ◽  
pp. 2193-2201 ◽  
Author(s):  
Mar Masiá ◽  
Jana Papassotiriou ◽  
Nils G Morgenthaler ◽  
Ildefonso Hernández ◽  
Conrado Shum ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Natriuretic Peptide ◽  
Prospective Observational Study ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Serum Samples ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Carboxy Terminal

Abstract Background: Markers to better assess severity of disease in patients with community-acquired pneumonia (CAP) would help improve medical care of this condition. The hemodynamic biomarkers carboxy-terminal provasopressin (CT-proAVP; copeptin) and midregional proatrial natriuretic peptide (MR-proANP) are increased under septic conditions, in which MR-proANP has been described as a prognostic predictor. We aimed to explore the diagnostic accuracy of MR-proANP and CT-proAVP to predict mortality in patients with CAP. Methods: We conducted a prospective observational study of patients with CAP. We measured biomarkers in serum samples obtained at diagnosis and performed univariate and multivariate analyses to identify potential predictors of mortality. Results: CT-proAVP and MR-proANP concentrations were measured in 173 patients. We found a positive correlation between pneumonia severity index (PSI) and MR-proANP (rs = 0.68, P &lt;0.0001) and between PSI and CT-proAVP (rs = 0.44, P &lt;0.0001). Median (interquartile range) CT-proAVP and MR-proANP values were 8.2 (5.3–16.8) and 73.6 (44.6–144.0) pmol/L, respectively. Nonsurvivors had significantly higher MR-proANP and CT-proAVP than survivors (median 259.0 vs 71.8 pmol/L, P = 0.01, and 24.9 vs 8.1 pmol/L, P = 0.03, respectively). In multivariate analysis including PSI, procalcitonin, C-reactive protein, lipopolysaccharide-binding protein, CT-proAVP, and MR-proANP concentrations, only CT-proAVP remained an independent predictor of death (odds ratio 1.05, P = 0.007). Cutoff values of &gt;18.9 pmol/L for CT-proAVP and &gt;227 pmol/L for MR-proANP showed the highest diagnostic accuracy to predict mortality. Conclusions: CT-proAVP and MR-proANP may be used to predict prognosis in patients with CAP.

scholarly journals Augmented reality navigation in spine surgery: a systematic review

2021 ◽  
Vol 163 (3) ◽  
pp. 843-852
Author(s):  
Gustav Burström ◽  
Oscar Persson ◽  
Erik Edström ◽  
Adrian Elmi-Terander
Keyword(s):  
Systematic Review ◽  
Augmented Reality ◽  
Spine Surgery ◽  
Surgical Navigation ◽  
Negative Impact ◽  
Cost Benefit ◽  
Final Analysis ◽  
Current Evidence ◽  
Current Evidence Base ◽  
Spinal Navigation

Abstract Background Conventional spinal navigation solutions have been criticized for having a negative impact on time in the operating room and workflow. AR navigation could potentially alleviate some of these concerns while retaining the benefits of navigated spine surgery. The objective of this study is to summarize the current evidence for using augmented reality (AR) navigation in spine surgery. Methods We performed a systematic review to explore the current evidence for using AR navigation in spine surgery. PubMed and Web of Science were searched from database inception to November 27, 2020, for data on the AR navigation solutions; the reported efficacy of the systems; and their impact on workflow, radiation, and cost-benefit relationships. Results In this systematic review, 28 studies were included in the final analysis. The main findings were superior workflow and non-inferior accuracy when comparing AR to free-hand (FH) or conventional surgical navigation techniques. A limited number of studies indicated decreased use of radiation. There were no studies reporting mortality, morbidity, or cost-benefit relationships. Conclusions AR provides a meaningful addition to FH surgery and traditional navigation methods for spine surgery. However, the current evidence base is limited and prospective studies on clinical outcomes and cost-benefit relationships are needed.

scholarly journals Assessment of the Therapeutic Effect of Total Glucosides of Peony for Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Yongsong Cai ◽  
Qiling Yuan ◽  
Ke Xu ◽  
Jialin Zhu ◽  
Yuanbo Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Juvenile Idiopathic Arthritis ◽  
Meta Analysis ◽  
Final Analysis ◽  
Tender Joint Count ◽  
Therapeutic Effects ◽  
Tender Joint ◽  
Reactive Protein ◽  
Total Glucosides Of Peony

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children; some clinical trials have reported the effects of total glucosides of peony (TGP) in the treatment of JIA. However, no systematic review has yet been conducted. In this study, we assessed the efficacy and safety in patients with JIA enrolled in randomized controlled trials (RCTs) of TGP. We extracted data for studies searched from 8 electronic databases that were searched and also evaluated the methodological quality of the included studies. We assessed the following outcome measures: overall response rate, pain, tender joint count (TJC), swollen joint count (SJC), duration of morning stiffness (DMS), grip strength (GS), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and adverse effects (AEs) in short term (4–8 weeks), intermediate term (9–26 weeks), and long term (>26 weeks). The final analysis showed that TGP acted as a unique nonbiologic disease-modifying antirheumatic drug (nonbiologic DMARD), and its therapeutic effects were safe and efficacious for the treatment of JIA with few AEs. However, more high-quality RCTs are needed to confirm these therapeutic effects.

scholarly journals Level of CRP predicts need for respiratory support in hospitalized COVID-19 patients

2020 ◽  
Author(s):  
Samuel Markowicz ◽  
Sunniva Donat ◽  
Eddy-Laurent Glaude ◽  
Jean-David Pommier ◽  
Elodie Curlier ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Disease Severity ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Respiratory Support ◽  
Ct Scans ◽  
Reactive Protein ◽  
Respiratory Parameters ◽  
Radiological Score ◽  
Relationship Of

Abstract PurposePredictors of disease severity in COVID-19 are essential to identify patients requiring hospitalization. Our aim was to determine the relationship of C-reactive protein (CRP) with the need for respiratory support.MethodsThis was a retrospective monocentric study of all patients hospitalized for confirmed COVID-19 pneumonia. CRP was measured on admission in the serum. Patients were classified using the Pneumonia Severity Index (PSI) and a 3-stage internal severity score (ISS) based upon respiratory parameters. Chest CT scans performed on admission were analysed following guidelines. Correlations of CRP levels with disease severity, radiological score, oxygen or mechanical ventilation requirement, and death were studied.Results61 patients were included from March 13th to April 8th, 2020. CRP levels were better related to the ISS compared to the PSI, being 18 (5-54), 130 (50-147) and 169 (97-241) mg/L respectively for the low, intermediate and high severity groups (p = 0.004 and p = 0.017). Analysis of the 51 available CT scans found a smaller correlation between CRP levels and radiological score (p < 0.05). The CRP levels were related to oxygen requirement (n = 50, p = 0.001), mechanical ventilation (n = 20, p = 0.004) and death (n = 10, p= 0.001).ConclusionCRP level on admission was a good marker of clinical and radiological severity in COVID-19 pneumonia, and could be used to identify patients needing hospitalization and intensive care.

scholarly journals A systematic review on diagnostics and surgical treatment of adult right-sided Bochdalek hernias and presentation of the current management pathway

Hernia ◽  
2021 ◽  
Author(s):  
J. P. Ramspott ◽  
T. Jäger ◽  
M. Lechner ◽  
P. Schredl ◽  
A. Gabersek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Treatment Strategies ◽  
Final Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
The Right ◽  
Meta Analyses

Abstract Purpose Bochdalek hernia is a congenital diaphragmatic hernia. The incidence in adults is estimated around 0.17%. Right-sided hernias are much more seldom than left-sided ones because of faster closure of the right pleuroperitoneal canal and the protective effect of the liver. Due to its rarity, there have been no large prospective or retrospective studies following great need for evidence-based diagnostics and treatment strategies. In this systematic review, we evaluated the current evidence of diagnostics, treatment, and follow-up of adult right-sided Bochdalek hernias. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines a systematic literature review was conducted in PubMed and Cochrane library from 2004 to January 2021. The literature search included all studies with non-traumatic right-sided Bochdalek hernias. Literature on left- or both-sided, pregnancy-associated, pediatric, and other types of hernias were explicitly excluded. Quality assessment of the included studies was performed. Results Database search identified 401 records. After eligibility screening 41 studies describing 44 cases of right-sided non-traumatic Bochdalek hernias in adulthood were included for final analysis. Based upon the systematic literature review, the current diagnostic, therapeutic, and follow-up management pathway for this rare surgical emergency is presented. Conclusion This systematic review underlined that most studies investigating management of adult non-traumatic right-sided Bochdalek hernias are of moderate to low methodological quality. Hernias tend to occur more frequently in middle-aged and older women presenting with abdominal pain and dyspnea. A rapid and accurate diagnosis following surgical repair and regular follow-up is mandatory. High-quality studies focusing on the management of this rare entity are urgently needed.

scholarly journals A Systematic Review about the Efficacy and Safety ofTripterygium wilfordiiHook.f. Preparations Used for the Management of Rheumatoid Arthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Jing Wang ◽  
Na Chen ◽  
Liang Fang ◽  
Zhe Feng ◽  
Guochun Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Chinese Herb ◽  
Current Evidence ◽  
Control Group ◽  
Efficacy And Safety ◽  
Tripterygium Wilfordii ◽  
Reactive Protein

Tripterygium wilfordiiHook.f. (TWHF) is a traditional Chinese herb long used for rheumatoid arthritis (RA) treatment, in modern times, often in the form of variousTripterygium wilfordiiHook.f. preparations (TWPs). This systematic review and meta-analysis focuses on analyzing the clinical efficacy and safety of TWPs in the treatment of RA. Databases were searched to collect the randomized controlled trials (RCTs) on TWPs treating RA published on or before April 10, 2017. Data from 11 studies were included in this meta-analysis. Compared with the control group, TWPs can increase effectiveness, while decreasing erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), and risk of adverse events. TWPs treatment was also more effective than treatment by conventional western medicine (CWM) and Chinese patent medicine or placebo (COP). TWPs significantly decreased the risk of adverse events compared with the CWM group, but not compared with the COP group. Current evidence shows that TWPs are more effective than other western or Chinese medicines we included in this meta-analysis for RA treatment with relatively lower toxicity.

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