巨细胞病毒再激活对免疫功能正常的重症患者临床结局的影响：一项系统评价和荟萃分析方案
Impact of cytomegalovirus reactivation on clinical outcomes in immunocompetent critically ill patients: protocol for a systematic review and meta-analysis.
作者信息
Lachance Philippe, Chen Justin, Featherstone Robin, Sligl Wendy
机构信息
Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124 Clinical Sciences Building, 8440 - 112th Street, Edmonton, Alberta, T6G 2B7, Canada.
Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
出版信息
Syst Rev. 2016 Jul 28;5(1):127. doi: 10.1186/s13643-016-0303-8.
BACKGROUND
Cytomegalovirus (CMV) reactivation in critically ill patients is a well-recognized phenomenon with an incidence as high as 71 %. A number of studies have investigated the association between CMV reactivation and outcomes in critically ill patients with conflicting results. We propose to conduct a systematic review and meta-analysis to determine the impact of CMV reactivation on patient-centered outcomes and measures of health resource utilization in immunocompetent critically ill patients.
METHODS
In consultation with a research librarian, a search strategy will be developed and electronic databases (i.e., Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL)) will be searched for original studies. Selected grey literature sources will be hand-searched. Search themes will include cytomegalovirus, intensive care unit, and sepsis. Citation screening, selection, quality assessment, and data abstraction will be performed in duplicate. Pooled effect estimates of the impact of CMV reactivation on selected patient-centered outcomes and measures of health resource utilization will be described.
DISCUSSION
This systematic review aims to explore the impact of CMV reactivation on patient-centered outcomes and health resource utilization in immunocompetent critically ill patients. Our results will help to better define the burden of disease associated with CMV reactivation. Indeed, evidence to date suggests increased mortality in this patient population. However, the relationship between CMV reactivation and health resource utilization remains less clear. Based on our results, future study on the impact of CMV treatment or prophylaxis on outcomes (including those other than mortality) may be warranted.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016035446.
背景
危重症患者中巨细胞病毒（CMV）再激活是一种公认的现象，发生率高达71%。许多研究调查了CMV再激活与危重症患者预后之间的关联，但结果相互矛盾。我们建议进行一项系统评价和荟萃分析，以确定CMV再激活对免疫功能正常的危重症患者以患者为中心的预后及卫生资源利用指标的影响。
方法
与一名研究馆员协商制定检索策略，检索电子数据库（即Ovid MEDLINE、Ovid EMBASE以及Cochrane图书馆，包括Cochrane系统评价数据库、Cochrane对照试验中心注册库（CENTRAL））以查找原始研究。对手动检索选定的灰色文献来源。检索主题将包括巨细胞病毒、重症监护病房和脓毒症。将由两人独立进行文献筛选、选择、质量评估和数据提取。将描述CMV再激活对选定的以患者为中心的预后及卫生资源利用指标影响的合并效应估计值。
讨论
本系统评价旨在探讨CMV再激活对免疫功能正常的危重症患者以患者为中心的预后及卫生资源利用的影响。我们的结果将有助于更好地界定与CMV再激活相关的疾病负担。事实上，迄今为止的证据表明该患者群体死亡率增加。然而，CMV再激活与卫生资源利用之间的关系仍不太明确。基于我们的结果可能有必要对CMV治疗或预防对预后（包括死亡率以外的预后）的影响开展进一步研究。
系统评价注册
PROSPERO CRD42016035446
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