Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.

<h4>Background</h4>In the current context of high fatality rates associated with American visceral leishmaniasis (VL), the appropriate use of prognostic factors to identify patients at higher risk of unfavorable outcomes represents a potential tool for clinical practice. This systematic...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Vinícius Silva Belo, Claudio José Struchiner, David Soeiro Barbosa, Bruno Warlley Leandro Nascimento, Marco Aurélio Pereira Horta, Eduardo Sérgio da Silva, Guilherme Loureiro Werneck
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/b74654567d104142af8cca02ddaebd27
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b74654567d104142af8cca02ddaebd27
record_format	dspace
spelling	oai:doaj.org-article:b74654567d104142af8cca02ddaebd272021-11-25T06:32:20ZRisk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.1935-27271935-273510.1371/journal.pntd.0002982https://doaj.org/article/b74654567d104142af8cca02ddaebd272014-07-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25058582/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>In the current context of high fatality rates associated with American visceral leishmaniasis (VL), the appropriate use of prognostic factors to identify patients at higher risk of unfavorable outcomes represents a potential tool for clinical practice. This systematic review brings together information reported in studies conducted in Latin America, on the potential predictors of adverse prognosis (continued evolution of the initial clinical conditions of the patient despite the implementation of treatment, independent of the occurrence of death) and death from VL. The limitations of the existing knowledge, the advances achieved and the approaches to be used in future research are presented.<h4>Methods/principal findings</h4>The full texts of 14 studies conforming to the inclusion criteria were analyzed and their methodological quality examined by means of a tool developed in the light of current research tools. Information regarding prognostic variables was synthesized using meta-analysis. Variables were grouped according to the strength of evidence considering summary measures, patterns and heterogeneity of effect-sizes, and the results of multivariate analyses. The strongest predictors identified in this review were jaundice, thrombocytopenia, hemorrhage, HIV coinfection, diarrhea, age <5 and age >40-50 years, severe neutropenia, dyspnoea and bacterial infections. Edema and low hemoglobin concentration were also associated with unfavorable outcomes. The main limitation identified was the absence of validation procedures for the few prognostic models developed so far.<h4>Conclusions/significance</h4>Integration of the results from different investigations conducted over the last 10 years enabled the identification of consistent prognostic variables that could be useful in recognizing and handling VL patients at higher risk of unfavorable outcomes. The development of externally validated prognostic models must be prioritized in future investigations.Vinícius Silva BeloClaudio José StruchinerDavid Soeiro BarbosaBruno Warlley Leandro NascimentoMarco Aurélio Pereira HortaEduardo Sérgio da SilvaGuilherme Loureiro WerneckPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 8, Iss 7, p e2982 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Vinícius Silva Belo Claudio José Struchiner David Soeiro Barbosa Bruno Warlley Leandro Nascimento Marco Aurélio Pereira Horta Eduardo Sérgio da Silva Guilherme Loureiro Werneck Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
description	<h4>Background</h4>In the current context of high fatality rates associated with American visceral leishmaniasis (VL), the appropriate use of prognostic factors to identify patients at higher risk of unfavorable outcomes represents a potential tool for clinical practice. This systematic review brings together information reported in studies conducted in Latin America, on the potential predictors of adverse prognosis (continued evolution of the initial clinical conditions of the patient despite the implementation of treatment, independent of the occurrence of death) and death from VL. The limitations of the existing knowledge, the advances achieved and the approaches to be used in future research are presented.<h4>Methods/principal findings</h4>The full texts of 14 studies conforming to the inclusion criteria were analyzed and their methodological quality examined by means of a tool developed in the light of current research tools. Information regarding prognostic variables was synthesized using meta-analysis. Variables were grouped according to the strength of evidence considering summary measures, patterns and heterogeneity of effect-sizes, and the results of multivariate analyses. The strongest predictors identified in this review were jaundice, thrombocytopenia, hemorrhage, HIV coinfection, diarrhea, age <5 and age >40-50 years, severe neutropenia, dyspnoea and bacterial infections. Edema and low hemoglobin concentration were also associated with unfavorable outcomes. The main limitation identified was the absence of validation procedures for the few prognostic models developed so far.<h4>Conclusions/significance</h4>Integration of the results from different investigations conducted over the last 10 years enabled the identification of consistent prognostic variables that could be useful in recognizing and handling VL patients at higher risk of unfavorable outcomes. The development of externally validated prognostic models must be prioritized in future investigations.
format	article
author	Vinícius Silva Belo Claudio José Struchiner David Soeiro Barbosa Bruno Warlley Leandro Nascimento Marco Aurélio Pereira Horta Eduardo Sérgio da Silva Guilherme Loureiro Werneck
author_facet	Vinícius Silva Belo Claudio José Struchiner David Soeiro Barbosa Bruno Warlley Leandro Nascimento Marco Aurélio Pereira Horta Eduardo Sérgio da Silva Guilherme Loureiro Werneck
author_sort	Vinícius Silva Belo
title	Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
title_short	Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
title_full	Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
title_fullStr	Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
title_full_unstemmed	Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.
title_sort	risk factors for adverse prognosis and death in american visceral leishmaniasis: a meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/b74654567d104142af8cca02ddaebd27
work_keys_str_mv	AT viniciussilvabelo riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT claudiojosestruchiner riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT davidsoeirobarbosa riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT brunowarlleyleandronascimento riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT marcoaureliopereirahorta riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT eduardosergiodasilva riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis AT guilhermeloureirowerneck riskfactorsforadverseprognosisanddeathinamericanvisceralleishmaniasisametaanalysis
_version_	1718413705984606208

Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis.

Ejemplares similares