ObjectiveTo evaluate the predictive value of critical illness scores for hospital mortality of severe respiratory diseases in respiratory intensive care unit (ICU).MethodsThe clinical data of the patients who needed intensive care and primary diagnosed with respiratory diseases from June, 2001 to Octomber, 2012 were extracted from MIMIC-Ⅲ database. The Acute Physiology Score (APS) Ⅲ, Simplified Acute Physiology Score (SAPS) Ⅱ, Oxford Acute Severity of Illness Score (OASIS), Logistic Organ Dysfunction System (LODS), Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) were calculated according to the requirements of each scoring system. ICU mortality was set up as primary outcome and receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performances by comparing the areas under ROC curve (AUC). According to whether they received invasive mechanical ventilation during ICU, the patients were divided into two groups (group A: without invasive mechanical ventilation group; group B: with invasive mechanical ventilation group). The AUCs of six scoring systems were calculated for groups A and B, and the ROC curves were compared independently.ResultsA total of 2988 patients were recruited, male accounted for 49.4%, median age was 67 (55, 79), and ICU mortality was 13.2%. The AUCs of SAPSⅡ, LODS, APSⅢ, OASIS, SOFA and SIRS were 0.73 (0.70, 0.75), 0.71 (0.68, 0.73), 0.69 (0.67, 0.72), 0.69 (0.67, 0.72), 0.67 (0.64, 0.70) and 0.58 (0.56, 0.62). Subgroup analysis showed that in group A, the AUCs of OASIS, SAPSⅡ, LODS, APSⅢ, SOFA and SIRS were 0.81 (0.76, 0.85), 0.80 (0.75, 0.85), 0.77 (0.72, 0.83), 0.75 (0.70, 0.80), 0.73 (0.68, 0.78) and 0.63 (0.56, 0.69) in the prediction of ICU mortality; in group B, the AUCs of SAPSⅡ, APSⅢ, LODS, SOFA, OASIS and SIRS were 0.68 (0.64, 0.71), 0.67 (0.63, 0.70), 0.65 (0.62, 0.69), 0.62 (0.59, 0.66), 0.62 (0.58, 0.65) and 0.57 (0.54, 0.61) in the prediction of ICU mortality. The results of independent ROC curve showed that the AUC differences between groups A and B were statistically significant in terms of OASIS, SAPSⅡ, LODS, APSⅢ and SOFA, but there were no significant differences in SIRS.ConclusionsThe predictive values of six critical illness scores for ICU mortality in respiratory intensive care are low. Lack of ability to predict ICU mortality of patients with invasive mechanical ventilation should hold primary responsibility.
Objective To assess the prognostic value of platelet-to-lymphocyte ratio (PLR) in small cell lung cancer (SCLC). Methods We searched PubMed, OVID, Cochrane Library, Wanfang database, China National Knowledge Infrastructure, and CQVIP database to obtain relevant literature published up to January 2022. We screened the literature, extracted data and evaluated the quality according to the inclusion and exclusion criteria, and then performed a meta-analysis by using the hazard risk (HR) and 95% confidence interval (CI) to assess the prognostic value of PLR. Results A total of 4261 patients with SCLC were included in 15 eligible studies. The results showed that high pretreatment PLR was negatively associated with overall survival (OS) [HR=1.311, 95%CI (1.125, 1.527), P=0.001], but not with progression-free survival (PFS) [HR=1.112, 95%CI (0.966, 1.280), P=0.139]. Subgroup analyses showed that high PLR had prognostic value in patients with limited period and limited period + extensive phase SCLC [limited period: HR=1.556, 95%CI (1.327, 1.824), P<0.001; limited period + extensive phase: HR=1.245, 95%CI (1.043, 1.486), P=0.015]; when the cut-off value of PLR was less than 150, the result was significant for patients with SCLC [HR=1.420, 95%CI (1.235, 1.631), P<0.001]; regardless of race, PLR had prognostic value in SCLC patients [Caucasian: HR=1.528, 95%CI (1.181, 1.976), P<0.001; Asian: HR=1.283, 95%CI (1.085, 1.517), P=0.004]. Conclusions High pretreatment PLR may be related to the poor prognosis of SCLC, especially limited period SCLC. PLR could be a prognostic factor in SCLC, but more larger-sample studies are still needed to verify that.
ObjectivesTo systematically review the prevalence of methicillin-resistant staphylococcus aureus (MRSA) in healthy Chinese population.MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies of the prevalence of MRSA in China from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 25 cross-sectional studies were included. The results of meta-analysis showed that: the pooled prevalence of MRSA in healthy population was 13.9% (95%CI 9.6% to 18.2%). The results of subgroup analysis showed that: the prevalence of MRSA in children was 16% (95%CI 8% to 24%), and that in adults (non-children) was 13% (95%CI 9% to 16%). The prevalence of MRSA in individuals with occupational livestock exposure was 28% (95%CI 5% to 51%), in medical staff it was 16% (95%CI 8% to 25%), in medical students it was 12% (95%CI 3% to 20%) and in community residents it was 5% (95%CI 2% to 8%).ConclusionsThe overall prevalence of MRSA in healthy Chinese population is approximately 13.9%. Effective prevention and control measures are required to reduce the spread of MRSA.