cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.29391051
title: Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis

description: A comprehensive investigation delineating the prevalence of sarcopenia across different infection phases, from acute COVID-19 to long COVID, is lacking. Meanwhile, the relationship between sarcopenia and adverse outcomes among COVID-19 patients remains inconsistent. A systematic search of MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus, before 22nd February 2025, was conducted to identify studies assessing sarcopenia prevalence in acute COVID-19 and long COVID. Random effects meta-analyses were performed to estimate the pooled prevalence of sarcopenia for acute COVID-19 and long COVID patients. Subgroup analyses stratified by assessment tool, region, income, hospitalization status, and age were performed. The associations between sarcopenia and COVID-19-related clinical outcomes were further quantified. A total of 39 studies with 6,982 individuals were included. The pooled prevalence of sarcopenia was 48.7% (95% confidence interval (CI): 39.6–57.9%) in acute COVID-19 and 23.5% (95% CI: 12.7–39.4%) in long COVID. In acute COVID-19 patients, sarcopenia was not significantly associated with length of stay (mean difference = 2.215, 95% CI: −0.004 to 4.433), mechanical ventilation (Odds ratio (OR) = 1.80, 95% CI: 0.84–3.85), admission to the intensive care unit (OR = 1.05, 95% CI: 0.63–1.77), or mortality (OR = 1.41, 95% CI: 0.86–2.32), but was significantly associated with tracheostomy (OR = 2.48, 95% CI: 1.28–4.82). In conclusion, our findings indicate that sarcopenia is highly prevalent in acute COVID-19 and persists in a substantial proportion of long COVID patients, suggesting prolonged muscle loss beyond the acute phase. Future well-designed studies are needed to further investigate the association between sarcopenia and short-term and long-term prognostic outcomes in both acute and long COVID patients.
DOI: 10.6084/m9.figshare.29391051.v1
title: Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis

description: A comprehensive investigation delineating the prevalence of sarcopenia across different infection phases, from acute COVID-19 to long COVID, is lacking. Meanwhile, the relationship between sarcopenia and adverse outcomes among COVID-19 patients remains inconsistent. A systematic search of MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus, before 22nd February 2025, was conducted to identify studies assessing sarcopenia prevalence in acute COVID-19 and long COVID. Random effects meta-analyses were performed to estimate the pooled prevalence of sarcopenia for acute COVID-19 and long COVID patients. Subgroup analyses stratified by assessment tool, region, income, hospitalization status, and age were performed. The associations between sarcopenia and COVID-19-related clinical outcomes were further quantified. A total of 39 studies with 6,982 individuals were included. The pooled prevalence of sarcopenia was 48.7% (95% confidence interval (CI): 39.6–57.9%) in acute COVID-19 and 23.5% (95% CI: 12.7–39.4%) in long COVID. In acute COVID-19 patients, sarcopenia was not significantly associated with length of stay (mean difference = 2.215, 95% CI: −0.004 to 4.433), mechanical ventilation (Odds ratio (OR) = 1.80, 95% CI: 0.84–3.85), admission to the intensive care unit (OR = 1.05, 95% CI: 0.63–1.77), or mortality (OR = 1.41, 95% CI: 0.86–2.32), but was significantly associated with tracheostomy (OR = 2.48, 95% CI: 1.28–4.82). In conclusion, our findings indicate that sarcopenia is highly prevalent in acute COVID-19 and persists in a substantial proportion of long COVID patients, suggesting prolonged muscle loss beyond the acute phase. Future well-designed studies are needed to further investigate the association between sarcopenia and short-term and long-term prognostic outcomes in both acute and long COVID patients.
DOI: 10.6084/m9.figshare.29874740
title: Effect of driving pressure-guided positive end-expiratory pressure on respiratory mechanics and clinical outcomes in surgical patients: a systematic review and meta-analysis of randomized controlled trials

description: Intraoperative driving pressure-guided positive end-expiratory pressure (PEEP<sub>dp</sub>) is effective for reducing postoperative pulmonary complications (PPCs). However, its impact on respiratory mechanics and clinical outcomes requires further elaboration. PubMed, the Cochrane Library, Web of Science and Embase were searched from inception to May 2024 for randomized controlled trials (RCTs) comparing the effect of PEEP<sub>dp</sub> with conventional fixed positive end-expiratory pressure (PEEP) in patients undergoing surgery. The primary outcomes were the effects on the driving pressure (DP), static respiratory compliance and plateau pressure (<i>P</i><sub>plat</sub>). Secondary outcomes included the effects on common clinical outcomes and the incidence of PPCs. Risk ratios or mean differences were pooled using fixed- or random-effects models. Nineteen RCTs involving 3744 patients were included. The mean of PEEP<sub>dp</sub> was 8.2 cmH<sub>2</sub>O with 95% CI from 7 cmH<sub>2</sub>O to 9.5 cmH<sub>2</sub>O, while the median of PEEP in the conventional group was 5 cmH<sub>2</sub>O with an interquartile range of 1 cmH<sub>2</sub>O. Patients in the PEEP<sub>dp</sub> group were ventilated with lower DP (mean: 10 cmH<sub>2</sub>O, 95% CI [8.8, 11.1] vs. mean: 11.9 cmH<sub>2</sub>O, 95% CI [10.6, 13.3]; <i>p</i> &lt; .00001), and increased respiratory compliance (mean: 46.4 ml/cmH<sub>2</sub>O, 95% CI [42.1, 50.7] vs. mean: 39 ml/cmH<sub>2</sub>O, 95% CI [35.2, 42.8]; <i>p</i> &lt; .0001) with nonsignificant <i>P</i><sub>plat</sub>. PEEP<sub>dp</sub> did not significantly affect intensive care unit (ICU) admission, mortality or length of hospital and ICU stay (<i>p</i> &gt; .05), but it reduced the incidence of PPCs (<i>p</i> = .001). The benefits were especially evident in patients undergoing abdominal surgery, those with DP less than 10 cmH<sub>2</sub>O or those with PEEP<sub>dp</sub> ranging from 5 to 10 cmH<sub>2</sub>O or when PEEP<sub>dp</sub> was titrated via a stepwise increase method (<i>p</i> &lt; .05). PEEP<sub>dp</sub> allows for ventilation with lower DP, improved static respiratory compliance and fewer PPCs. No significant effects were observed on broader clinical outcomes per current data.
DOI: 10.6084/m9.figshare.29874740.v1
title: Effect of driving pressure-guided positive end-expiratory pressure on respiratory mechanics and clinical outcomes in surgical patients: a systematic review and meta-analysis of randomized controlled trials

description: Intraoperative driving pressure-guided positive end-expiratory pressure (PEEP<sub>dp</sub>) is effective for reducing postoperative pulmonary complications (PPCs). However, its impact on respiratory mechanics and clinical outcomes requires further elaboration. PubMed, the Cochrane Library, Web of Science and Embase were searched from inception to May 2024 for randomized controlled trials (RCTs) comparing the effect of PEEP<sub>dp</sub> with conventional fixed positive end-expiratory pressure (PEEP) in patients undergoing surgery. The primary outcomes were the effects on the driving pressure (DP), static respiratory compliance and plateau pressure (<i>P</i><sub>plat</sub>). Secondary outcomes included the effects on common clinical outcomes and the incidence of PPCs. Risk ratios or mean differences were pooled using fixed- or random-effects models. Nineteen RCTs involving 3744 patients were included. The mean of PEEP<sub>dp</sub> was 8.2 cmH<sub>2</sub>O with 95% CI from 7 cmH<sub>2</sub>O to 9.5 cmH<sub>2</sub>O, while the median of PEEP in the conventional group was 5 cmH<sub>2</sub>O with an interquartile range of 1 cmH<sub>2</sub>O. Patients in the PEEP<sub>dp</sub> group were ventilated with lower DP (mean: 10 cmH<sub>2</sub>O, 95% CI [8.8, 11.1] vs. mean: 11.9 cmH<sub>2</sub>O, 95% CI [10.6, 13.3]; <i>p</i> &lt; .00001), and increased respiratory compliance (mean: 46.4 ml/cmH<sub>2</sub>O, 95% CI [42.1, 50.7] vs. mean: 39 ml/cmH<sub>2</sub>O, 95% CI [35.2, 42.8]; <i>p</i> &lt; .0001) with nonsignificant <i>P</i><sub>plat</sub>. PEEP<sub>dp</sub> did not significantly affect intensive care unit (ICU) admission, mortality or length of hospital and ICU stay (<i>p</i> &gt; .05), but it reduced the incidence of PPCs (<i>p</i> = .001). The benefits were especially evident in patients undergoing abdominal surgery, those with DP less than 10 cmH<sub>2</sub>O or those with PEEP<sub>dp</sub> ranging from 5 to 10 cmH<sub>2</sub>O or when PEEP<sub>dp</sub> was titrated via a stepwise increase method (<i>p</i> &lt; .05). PEEP<sub>dp</sub> allows for ventilation with lower DP, improved static respiratory compliance and fewer PPCs. No significant effects were observed on broader clinical outcomes per current data.
DOI: 10.6084/m9.figshare.28547991
title: Association of time to red blood cell transfusion on outcomes in patients with gastrointestinal bleeding

description: Red blood cell transfusion is frequently prescribed in the emergency department for patients with gastrointestinal bleeding (GIB), but the association of time to transfusion with patient outcome has not been thoroughly evaluated. A retrospective cohort study analyzed adult patient data with GIB who visited the emergency department of single university-affiliated hospital between January 2016 and April 2022. The associations of time to transfusion and patient outcomes, 30-day and in-hospital mortality, were assessed. Among a total of 2,284 patients, 1,395 (61.1%) received red blood cell transfusion within 4 h of emergency department admission. Analysis of the time to transfusion showed the association between late transfusion (transfusion after 4 h) and the risk of 30-day mortality (adjusted hazard ratio, 1.65, 95% CI 1.17–2.32, <i>p</i> = .004) and in-hospital mortality (adjusted odds ratio 1.71, 95% CI 1.24–2.35, <i>p</i> &lt; .001). Subgroup analysis revealed that the association between time to transfusion and 30-day mortality was found only in those with upper GIB, nonvariceal bleeding and a low haemoglobin level (&lt;7.5 g/dL). Early transfusion was associated with higher 30-day transfusion demand, while no associations with length of stay and adverse transfusion reaction were noted. In this study, a longer time to red blood cell transfusion was associated with an increased risk of 30-day and in-hospital mortality of patients with GIB, especially in those with upper GIB, nonvariceal bleeding and a low haemoglobin level. In the emergency department, prompt red blood cell transfusion decisions for patients with GIB may improve patient outcomes.
DOI: 10.6084/m9.figshare.28547991.v1
title: Association of time to red blood cell transfusion on outcomes in patients with gastrointestinal bleeding

description: Red blood cell transfusion is frequently prescribed in the emergency department for patients with gastrointestinal bleeding (GIB), but the association of time to transfusion with patient outcome has not been thoroughly evaluated. A retrospective cohort study analyzed adult patient data with GIB who visited the emergency department of single university-affiliated hospital between January 2016 and April 2022. The associations of time to transfusion and patient outcomes, 30-day and in-hospital mortality, were assessed. Among a total of 2,284 patients, 1,395 (61.1%) received red blood cell transfusion within 4 h of emergency department admission. Analysis of the time to transfusion showed the association between late transfusion (transfusion after 4 h) and the risk of 30-day mortality (adjusted hazard ratio, 1.65, 95% CI 1.17–2.32, <i>p</i> = .004) and in-hospital mortality (adjusted odds ratio 1.71, 95% CI 1.24–2.35, <i>p</i> &lt; .001). Subgroup analysis revealed that the association between time to transfusion and 30-day mortality was found only in those with upper GIB, nonvariceal bleeding and a low haemoglobin level (&lt;7.5 g/dL). Early transfusion was associated with higher 30-day transfusion demand, while no associations with length of stay and adverse transfusion reaction were noted. In this study, a longer time to red blood cell transfusion was associated with an increased risk of 30-day and in-hospital mortality of patients with GIB, especially in those with upper GIB, nonvariceal bleeding and a low haemoglobin level. In the emergency department, prompt red blood cell transfusion decisions for patients with GIB may improve patient outcomes.
DOI: 10.6084/m9.figshare.28638367
title: Long-term prognostic value of thyroid hormone levels in chronic critical illness patients

description: Chronic critical illness (CCI) can manifest as dysfunction of thyroid hormones. This study aimed to investigate the predictive value of the nonthyroidal illness syndrome (NTIS) for the prognosis of CCI patients, establish a predictive model for the prognosis of CCI patients, and evaluate the efficacy of the model to provide a theoretical basis for clinical intervention. This was a prospective observational study in which patients ≥18 years old who met the CCI criteria were enrolled. The primary outcome of the study was 90-day mortality after intensive care unit (ICU) admission. A nomogram was constructed to predict the prognosis of CCI patients, and the model was evaluated via the concordance index, calibration curve and decision curve analysis. A total of 545 patients were included, and NTIS patients accounted for 65.3% of the patients. CCI patients with NTIS had more ventilator days and higher 90-day mortality. Lower free triiodothyronine (FT3) levels (&lt;1.19 pmol/L) or reduced free thyroxine (FT<sub>4</sub>) levels (&lt;9.655 pmol/L) were significantly associated with reduced survival in CCI patients with NTIS. Older age, a higher Sequential Organ Failure Assessment (SOFA) score, an emergency other than a traumatic operation, and a lower FT4 and thyroid-stimulating hormone level were found to be independent prognostic factors for a fatal outcome in CCI patients. The <i>C</i>-index for the prediction nomogram was 0.734, and the bias-corrected <i>C</i>-index was 0.727. The area under the receiver operating characteristic curve of our prediction model was superior to that of the SOFA and Acute Physiology and Chronic Health Evaluation II scores. Decreased serum FT3 and FT4 concentrations in patients with CCI at admission to the ICU on day 10 are associated with 90-day mortality. Early detection of serum FT3 and FT4 levels could help clinicians target CCI patients at high risk of clinical deterioration.
DOI: 10.6084/m9.figshare.28638367.v1
title: Long-term prognostic value of thyroid hormone levels in chronic critical illness patients

description: Chronic critical illness (CCI) can manifest as dysfunction of thyroid hormones. This study aimed to investigate the predictive value of the nonthyroidal illness syndrome (NTIS) for the prognosis of CCI patients, establish a predictive model for the prognosis of CCI patients, and evaluate the efficacy of the model to provide a theoretical basis for clinical intervention. This was a prospective observational study in which patients ≥18 years old who met the CCI criteria were enrolled. The primary outcome of the study was 90-day mortality after intensive care unit (ICU) admission. A nomogram was constructed to predict the prognosis of CCI patients, and the model was evaluated via the concordance index, calibration curve and decision curve analysis. A total of 545 patients were included, and NTIS patients accounted for 65.3% of the patients. CCI patients with NTIS had more ventilator days and higher 90-day mortality. Lower free triiodothyronine (FT3) levels (&lt;1.19 pmol/L) or reduced free thyroxine (FT<sub>4</sub>) levels (&lt;9.655 pmol/L) were significantly associated with reduced survival in CCI patients with NTIS. Older age, a higher Sequential Organ Failure Assessment (SOFA) score, an emergency other than a traumatic operation, and a lower FT4 and thyroid-stimulating hormone level were found to be independent prognostic factors for a fatal outcome in CCI patients. The <i>C</i>-index for the prediction nomogram was 0.734, and the bias-corrected <i>C</i>-index was 0.727. The area under the receiver operating characteristic curve of our prediction model was superior to that of the SOFA and Acute Physiology and Chronic Health Evaluation II scores. Decreased serum FT3 and FT4 concentrations in patients with CCI at admission to the ICU on day 10 are associated with 90-day mortality. Early detection of serum FT3 and FT4 levels could help clinicians target CCI patients at high risk of clinical deterioration.
DOI: 10.6084/m9.figshare.30152977
title: The value of plasma presepsin as a diagnostic and prognostic biomarker for febrile neutropenia in children

description: Febrile neutropenia (FN) is a prevalent infectious complication in paediatric cancer patients undergoing anticancer treatment. Presepsin is a reliable biomarker for sepsis; however, its clinical value in the context of paediatric FN remains unclear. This study aimed to evaluate the efficacy of presepsin in the entire course of paediatric patients with FN. In this prospective study, 108 paediatric patients with haematological tumours complicated with neutropenia were recruited, of whom 23 had febrile neutropenia. Blood samples were collected daily, and four inflammation biomarkers, presepsin, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP), were analyzed. Clinical and laboratory parameters were collected, and the diagnostic and prognostic value of biomarkers for FN was assessed. The concentrations of presepsin, PCT, IL-6 and CRP were prospectively measured in 57 FN episodes in 23 cases of malignant haematological diseases in children. The concentrations of presepsin, PCT and CRP were significantly elevated 72 h before onset compared to those in the control group. Only the concentration of presepsin at FN onset was significantly higher than 72 h before FN onset. The area under the curve (AUC) of presepsin, PCT, IL-6 and CRP for FN diagnosis 24 h before FN onset were 0.9118, 0.8214, 0.9052 and 0.8286, respectively. For prognosis, the levels of presepsin were consistently and significantly higher at every time point in patients with unfavourable outcomes than in those with favourable outcomes. Presepsin demonstrated the best performance in both the early diagnosis and prognosis assessment of FN, indicating that it is a reliable biomarker for managing the entire FN process. Close monitoring of presepsin may enable earlier intervention for FN, reducing the occurrence of adverse events caused by infection.
DOI: 10.6084/m9.figshare.30152977.v1
title: The value of plasma presepsin as a diagnostic and prognostic biomarker for febrile neutropenia in children

description: Febrile neutropenia (FN) is a prevalent infectious complication in paediatric cancer patients undergoing anticancer treatment. Presepsin is a reliable biomarker for sepsis; however, its clinical value in the context of paediatric FN remains unclear. This study aimed to evaluate the efficacy of presepsin in the entire course of paediatric patients with FN. In this prospective study, 108 paediatric patients with haematological tumours complicated with neutropenia were recruited, of whom 23 had febrile neutropenia. Blood samples were collected daily, and four inflammation biomarkers, presepsin, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP), were analyzed. Clinical and laboratory parameters were collected, and the diagnostic and prognostic value of biomarkers for FN was assessed. The concentrations of presepsin, PCT, IL-6 and CRP were prospectively measured in 57 FN episodes in 23 cases of malignant haematological diseases in children. The concentrations of presepsin, PCT and CRP were significantly elevated 72 h before onset compared to those in the control group. Only the concentration of presepsin at FN onset was significantly higher than 72 h before FN onset. The area under the curve (AUC) of presepsin, PCT, IL-6 and CRP for FN diagnosis 24 h before FN onset were 0.9118, 0.8214, 0.9052 and 0.8286, respectively. For prognosis, the levels of presepsin were consistently and significantly higher at every time point in patients with unfavourable outcomes than in those with favourable outcomes. Presepsin demonstrated the best performance in both the early diagnosis and prognosis assessment of FN, indicating that it is a reliable biomarker for managing the entire FN process. Close monitoring of presepsin may enable earlier intervention for FN, reducing the occurrence of adverse events caused by infection.
DOI: 10.6084/m9.figshare.30675962
title: A machine-learning model to identify concurrent vascular disease in symptomatic patients with chronic obstructive pulmonary disease

description: Chronic obstructive pulmonary disease (COPD) is a complex, heterogeneous syndrome often accompanied by vascular diseases that worsen prognosis and quality of life. This study aimed to develop a machine learning model to identify concurrent vascular diseases in symptomatic COPD patients. We retrospectively analyzed data from 6,274 COPD patients treated between July 2010 and July 2018. Patients were randomly split into training and validation sets (7:3). After feature selection using LASSO regression, eight machine learning algorithms—including Logistic Regression, Random Forest, Gradient Boosting, Support Vector Machine, Neural Network, Convolutional Neural Network, AdaBoost, and Stacked Generalization (Stacking)—were applied to develop and validate predictive models. Performance was evaluated using AUC, calibration curves, and decision curve analysis (DCA). The Stacking model achieved the highest AUC (0.867; 95% CI: 0.852–0.882), with 79.4% accuracy, 74.9% sensitivity, and 84.0% specificity. It also demonstrated excellent calibration and, on DCA, provided the highest net clinical benefit within the threshold probability range of 0.1–0.5. At a 0.2 threshold, the model could prevent approximately 35% of unnecessary interventions compared to a "treat-all" approach, while identifying about 75% of high-risk patients relative to a "treat-none" strategy. The Stacking machine-learning model showed superior performance in identifying concurrent vascular disease among symptomatic COPD patients, offering strong discriminative ability, calibration, and clinical utility. It may serve as an effective decision-support tool to optimize diagnostic evaluation in this high-risk subgroup.