Conectar
by Zhenzhen Li, Lili Cui, Jing Sun, Wanlu Liu
ObjectiveThe relationship among body mass index (BMI), postoperative complications, and clinical outcomes in patients undergoing gastrectomy for gastric cancer remains unclear. This study aimed to evaluate this association using a meta-analysis.
MethodWe conducted a systematic search of the PubMed, Embase, and Cochrane Library databases up to February 25, 2024. Patients were classified into underweight (2), normal weight (18.5–25.0 kg/m2), and overweight (≥25.0 kg/m2) groups based on BMI categories. Meta-analysis was performed using a random-effects model. Additionally, exploratory sensitivity and subgroup analyses were performed.
ResultsTwenty-two studies involving 41,144 patients with gastric cancer were included for quantitative analysis. Preoperative underweight (odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.03–1.55; P = 0.024) and overweight (OR: 1.19; 95%CI: 1.09–1.30; P P P P = 0.069), whereas preoperative overweight was associated with longer disease-free survival (HR: 0.80; 95%CI: 0.70–0.91; P = 0.001). In terms of specific postoperative complications, preoperative underweight was associated with an increased risk of septic shock (OR: 3.40; 95%CI: 1.26–9.17; P = 0.015) and a reduced risk of fever (OR: 0.39; 95%CI: 0.18–0.83; P = 0.014). Preoperative overweight was associated with an increased risk of wound infections (OR: 1.78; 95%CI: 1.08–2.93; P = 0.023), intestinal fistula (OR: 5.23; 95%CI: 1.93–14.21; P = 0.001), arrhythmia (OR: 6.38; 95%CI: 1.70–24.01; P = 0.006), and pancreatic fistula (OR: 3.37; 95%CI: 1.14–9.96; P = 0.028).
ConclusionThis study revealed that both preoperative underweight and overweight status were associated with an increased risk of postoperative complications. Moreover, the postoperative survival outcomes were significantly better in overweight compared to that of underweight patients.
Trial registrationRegistration: INPLASY202480004.
Current guidelines stress the importance of exercise, especially multicomponent exercise to older adults with chronic conditions.
To critically synthesise evidence that evaluates the effects of multicomponent exercise on quality of life, depression and anxiety after stroke.
Systematic review and meta-analysis followed the PRISMA 2020 statement.
A systematic search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL and PsycINFO from inception to 12 June 2023 was performed. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2). Meta-analyses were conducted using Review Manager 5.4 and narrative syntheses were adopted whenever meta-analysis was inappropriate. The overall certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Of 15,351 records identified, nine were eligible and data were available for seven randomised controlled trials, three of which were identified as having a high risk of bias, one as low risk, and five as having some concerns. Subgroup pooled analyses indicated that multicomponent exercise engaged in longer exercise sessions (>60 min) was effective in improving quality of life immediately post-intervention and through 3–6 months post-intervention. However, multicomponent exercise did not significantly affect depression and anxiety.
Multicomponent exercise with longer duration of exercise sessions has promising effects on both short- to medium-term quality of life among stroke survivors.
This does not apply to our work as it is a review paper.
Healthcare providers could consider encouraging the patients to participate in multicomponent exercise sessions for more than 60 min. It is important to note that stroke survivors should be supervised by trained personnel at the beginning of the training.
The protocol was registered on PROSPERO.
FreshRSS 