Association between stress hyperglycemia and pneumonia in patients with stroke: a systematic review and meta-analysis
Notice bibliographique
Résumé
BACKGROUND: Pneumonia is a frequent complication post-stroke and stress hyperglycemia (SH) is a physiological response to stroke. Although some studies have provided data on the impact of stress hyperglycemia on pneumonia incidence, no study to date has exclusively focused on investigating the direct relationship between stress hyperglycemia and pneumonia. METHODS: A comprehensive literature search was conducted across PubMed, EBSCOhost, Web of Science, Embase, CNKI, and Wanfang databases from inception to July 10th, 2024, to identify observational studies comparing the incidence of pneumonia between stroke patients with and without stress hyperglycemia. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS), and pooled ORs for each comparison were estimated using a random-effects model proposed by DerSimonian and Kacker. This systematic review is presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. RESULTS: Twelve studies were included eventually and the pooled incidence rate of pneumonia was 14.4%. The overall incidence of pneumonia in patients with stress hyperglycemia was significantly higher than in those without stress hyperglycemia (OR: 2.01; 95% CI: 1.72 to 2.34, P < 0.01).Significant heterogeneity was observed in the meta-analysis (P = 0.01, I²=54%). Meta-regression revealed that the effect size differed significantly across subgroups defined by SH metrics (blood glucose versus stress hyperglycemia ratio and blood glucose to HbA1c ratio, p < 0.01). These findings underscore important limitations, including measurement variability, significant heterogeneity, and potential residual confounding due to factors such as dysphagia severity, comorbidity burden, and variations in clinical management. Importantly, the overall quality of evidence was rated as low based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, primarily due to the observational design of the included studies and inconsistency across results. Therefore, the findings should be interpreted cautiously and regarded as hypothesis-generating. CONCLUSIONS: This systematic review and meta-analysis found that SH was significantly associated with post-stroke pneumonia, with patients exhibiting SH having twice the odds of pneumonia compared to those without. PROSPECTIVE REGISTRATION: The protocol for this review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024563263.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,010 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».