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Start Over Descriptor "HEMATOLOGY PATIENTS" Publisher biomed central
2 results on '"HEMATOLOGY PATIENTS"'

1. Clinical and diagnostic values of metagenomic next-generation sequencing for infection in hematology patients: a systematic review and meta-analysis.

Author

Chen, Yuhui, Wang, Jinjin, and Niu, Ting

Subjects
*NUCLEOTIDE sequencing, *METAGENOMICS, *HEMATOLOGY, *SENSITIVITY & specificity (Statistics), *INFECTION
Abstract

Objectives: This meta-analysis focused on systematically assessing the clinical value of mNGS for infection in hematology patients. Methods: We searched for studies that assessed the clinical value of mNGS for infection in hematology patients published in Embase, PubMed, Cochrane Library, Web of Science, and CNKI from inception to August 30, 2023. We compared the detection positive rate of pathogen for mNGS and conventional microbiological tests (CMTs). The diagnostic metrics, antibiotic adjustment rate and treatment effective rate were combined. Results: Twenty-two studies with 2325 patients were included. The positive rate of mNGS was higher than that of CMT (blood: 71.64% vs. 24.82%, P < 0.001; BALF: 89.86% vs. 20.78%, P < 0.001; mixed specimens: 82.02% vs. 28.12%, P < 0.001). The pooled sensitivity and specificity were 87% (95%CI: 81–91%) and 59% (95%CI: 43–72%), respectively. The reference standard/neutropenia and research type/reference standard may be sources of heterogeneity in sensitivity and specificity, respectively. The pooled antibiotic adjustment rate according to mNGS was 49.6% (95% CI: 41.8–57.4%), and the pooled effective rate was 80.9% (95% CI: 62.4–99.3%). Conclusion: mNGS has high positive detection rates in hematology patients. mNGS can guide clinical antibiotic adjustments and improve prognosis, especially in China. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data

Author

Marlies Ostermann, Alice Mânica Müller, Anne-Claire Toffart, Kyeongman Jeon, Christelle Ferra, Djamel Mokart, Quentin A. Hill, Pieter Depuydt, Pascale Gruber, Michael Darmon, Elie Azoulay, Peter Schellongowski, Marcio Soares, Quentin Georges, Aurélie Bourmaud, Chin Kook Rhee, Virginie Lemiale, Fabien Tinquaut, and Sandra Oeyen

Subjects
medicine.medical_specialty, INTENSIVE-CARE-UNIT, Neutropenia, medicine.medical_treatment, Critical Illness, RESPIRATORY-DISTRESS-SYNDROME, Outcomes, Critical Care and Intensive Care Medicine, FEBRILE NEUTROPENIA, law.invention, 03 medical and health sciences, 0302 clinical medicine, PROGNOSTIC-FACTORS, Mechanical ventilation, LONG-TERM OUTCOMES, Hematologic, law, Internal medicine, Neoplasms, Granulocyte Colony-Stimulating Factor, Outcome Assessment, Health Care, medicine, Medicine and Health Sciences, Humans, HEMATOLOGY PATIENTS, Intensive care units, business.industry, Research, Confounding, SEPTIC SHOCK, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Cancer, 030208 emergency & critical care medicine, PATIENTS RECEIVING CHEMOTHERAPY, lcsh:RC86-88.9, COLONY-STIMULATING FACTOR, medicine.disease, Prognosis, Intensive care unit, Respiration, Artificial, 3. Good health, Granulocyte colony-stimulating factor, ONCOLOGY PATIENTS, 030220 oncology & carcinogenesis, Meta-analysis, business, Febrile neutropenia
Abstract

Background The study objective was to assess the influence of neutropenia on outcome of critically ill cancer patients by meta-analysis of individual data. Secondary objectives were to assess the influence of neutropenia on outcome of critically ill patients in prespecified subgroups (according to underlying tumor, period of admission, need for mechanical ventilation and use of granulocyte colony stimulating factor (G-CSF)). Methods Data sources were PubMed and the Cochrane database. Study selection included articles focusing on critically ill cancer patients published in English and studies in humans from May 2005 to May 2015. For study selection, the study eligibility was assessed by two investigators. Individual data from selected studies were obtained from corresponding authors. Results Overall, 114 studies were identified and authors of 30 studies (26.3% of selected studies) agreed to participate in this study. Of the 7515 included patients, three were excluded due to a missing major variable (neutropenia or mortality) leading to analysis of 7512 patients, including 1702 neutropenic patients (22.6%). After adjustment for confounders, and taking study effect into account, neutropenia was independently associated with mortality (OR 1.41; 95% CI 1.23–1.62; P = 0.03). When analyzed separately, neither admission period, underlying malignancy nor need for mechanical ventilation modified the prognostic influence of neutropenia on outcome. However, among patients for whom data on G-CSF administration were available (n = 1949; 25.9%), neutropenia was no longer associated with outcome in patients receiving G-CSF (OR 1.03; 95% CI 0.70–1.51; P = 0.90). Conclusion Among 7512 critically ill cancer patients included in this systematic review, neutropenia was independently associated with poor outcome despite a meaningful survival. Neutropenia was no longer significantly associated with outcome in patients treated by G-CSF, which may suggest a beneficial effect of G-CSF in neutropenic critically ill cancer patients. Systematic review registration PROSPERO CRD42015026347. Date of registration: Sept 18 2015 Electronic supplementary material The online version of this article (10.1186/s13054-018-2076-z) contains supplementary material, which is available to authorized users.

Published
2018

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