Search

Background: Central catheter bloodstream infections (CRBSI) is a major cause of healthcare-associated infections. However, few factors are generally accepted and some studies have conflicting finding about some factors, possibly caused by limitation associated with an individual study. This study was to identify risk factors for CRBSI in intensive care units. Methods: We searched the PubMed, Cochrane Library, Web of science and EMBASE databases and the 4 top Chinese-language databases, including WanFang data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM) as of July 2023. Case control and cohort studies were included. Two authors independently screened the literature and evaluated the quality of the studies using the Newcastle-Ottawa scale (NOS). The pooled effect size was estimated using the odds ratio (OR), and the corresponding 95% confidence interval (CI) was calculated. The Cochrane Q (χ2) and I2 tests were used to assess heterogeneity among studies, and each risk factor was tested for its robustness using fixed- or random-effects models. Findings: A total of 32 studies enrolled, among which eleven factors were identified, they were divided into two categories: modifiable and unmodifiable factors. Modifiable factors: duration of catheterization (≥ 5d) (OR: 2.07, 95%CI: 1.41–3.03), duration of catheterization (≥ 7d) (OR: 3.62, 95%CI: 2.65–4.97), duration of catheterization (≥ 14d)(OR: 4.85, 95%CI: 3.35–7.01), total parenteral nutrition (OR: 2.27,95%CI: 1.56–3.29), use of multiple-lumen catheters(OR: 3.41, 95%CI: 2.27–5.11), times of tube indwelling (OR: 3.50, 95%CI: 2.93–4.17), length of ICU stay (OR: 4.05, 95%CI: 2.41–6.80), the position of indwelling(OR: 2.41, 95%CI: 2.03–2.85); Unmodifiable factors: APACHEII scores (OR: 1.84, 95%CI: 1.54–2.20), Age≥ 60 years old (OR: 2.19, 95%CI: 1.76–2.73), the extensive use of antibiotic (OR: 3.54, 95%CI: 1.65–7.61), Diabetes mellitus (OR: 3.06, 95%CI: 2.56–3.66), Immunosuppression (OR: 2.87, 95%CI: 2.08–3.95). Conclusions: Effective interventions targeting the above modifiable factors may reduce the risk of developing CRBSI in ICU and improve the clinical outcome of patients. Further prospective studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of 10 formulas for calculating intraocular lens (IOL) power in cataract eye with an axial length (AL) of more than 28.0 mm. Methods: We searched scientific databases including PubMed, EMBASE, Web of Science and Cochrane Library for research published over the past 5 years, up to Sept 2023. The inclusion criteria were case series studies that compared different formulas (Barrett II, EVO, Kane, Hill-RBF, Haigis, Hoffer Q, Holladay 1, SRK/T, Holladay 1 w-k and SRK/T w-k), in patients with extremely long AL undergoing uncomplicated cataract surgery with IOL implantation. The mean difference (MD) of mean absolute error (MAE) and the odds ratio (OR) of both the percentage of eyes within ±0.50D of prediction error (PPE±0.50D) and the percentage of eyes within ±1.00D of prediction error (PPE±1.00D) among different formulas were pooled using meta-analysis. Results: A total of 11 studies, involving 1376 eyes, were included to evaluate the 10 formulas mentioned above. Among these formulas, Barrett II, EVO, Kane, and Hill-RBF demonstrated significantly lower MAE values compared to SRK/T. Furthermore, Kane and Hill-RBF had lower MAE values than EVO. Additionally, Barrett II and Kane yielded significantly lower MAE values than Haigis while Hill-RBF showed significantly lower MAE values than Holladay 1. Moreover, Hill-RBF showed the highest values for both PPE±0.50D and PPE±1.00D, followed by Kane. Both EVO and Kane had higher values of PPE±0.50D and PPE±1.00D compared to Haigis and SRK/T. Conclusion: The Wang-Koch adjusted formulas and new-generation formulas have shown potential for higher accuracy in predicting IOL power for cataract patients with extremely long AL compared to traditional formulas. Based on the current limited clinical studies, Hill-RBF and Kane formulas seem to be a better choice for eyes with extremely long AL. [ABSTRACT FROM AUTHOR]