To account for time factors related to hospitalization, the authors calculated incidence rates of surgical site infection (SSI) instead of cumulative incidence and assessed risk factors for SSI after cardiac surgery. From July 1999 to August 2000, all cardiac surgery patients in the Taipei Veterans General Hospital (Taipei, Taiwan) were invited to join the study. Data were collected by chart review, including information on patient characteristics and potential risk factors at the preoperative, intraoperative, and postoperative stages. The authors employed multiple logistic regression analyses using a generalized logit model to assess associations of interest. SSI incidence rates were 2.5 episodes per 1,000 person-days for the sternum and 3.6 episodes per 1,000 person-days for the leg. After adjustment for covariates, age (in years), gender (female vs. male), New York Heart Association classification (moderate/severe vs. normal/mild), creatinine concentration (mg/dl), and duration of surgery (in minutes) were significantly associated with sternal SSI, while age, peripheral arterial occlusive disease, and length of stay in the intensive care unit (in hours) were significantly associated with leg SSI. In addition to patients' characteristics and health situations, the significant findings for duration of surgery and length of intensive care unit stay indicate that the incidence rate is more appropriate than cumulative incidence for studying risk factors for SSI.
Background: Recent epidemiological studies remain controversial regarding the association between statin use and reducing the risk of mortality among individuals with COVID-19. Objective: The objective of this study was to clarify the association between statin use and the risk of mortality among patients with COVID-19. Methods: We conducted a systematic articles search of online databases (PubMed, EMBASE, Scopus, and Web of Science) between 1 February 2020 and 20 February 2021, with no restriction on language. The following search terms were used: “Statins” and “COVID-19 mortality or COVID19 mortality or SARS-CoV-2 related mortality”. Two authors individually examined all articles and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study inclusion and exclusion. The overall risk ratio (RRs) with 95% confidence interval (CI) was calculated to show the strength of the association and the heterogeneity among the studies was presented Q and I2 statistic. Results: Twenty-eight studies were assessed for eligibility and 22 studies met the inclusion criteria. Statin use was associated with a significantly decreased risk of mortality among patients with COVID-19 (RR adjusted = 0.64; 95% CI: 0.57–0.72, p < 0.001). Moreover, statin use both before and after the admission was associated with lowering the risk of mortality among the COVID-19 patients (RR adjusted;before = 0.69; 95% CI: 0.56–0.84, p < 0.001 and RR adjusted;after = 0.57; 95% CI: 0.54–0.60, p < 0.001). Conclusion: This comprehensive study showed that statin use is associated with a decreased risk of mortality among individuals with COVID-19. A randomized control trial is needed to confirm and refute the association between them.
The potential impact of statins on the risk of Parkinson’s disease (PD) is still controversial; therefore, we conducted a comprehensive meta-analysis of observational studies to examine the effect of statin use on the risk of PD. We searched electronic databases, such as PubMed, EMBASE, Scopus, and Web of Science, for articles published between 1 January 2000 and 15 March 2022. Cohort studies which examined the association between statins and PD risk in the general population were also included. Two authors assessed the data and extracted all potential information for analysis. Random effects meta-analyses were performed to measure the risk ratio (RR) and 95% confidence intervals (CIs). Eighteen cohort studies including 3.7 million individuals with 31,153 PD participants were identified. In statin users, compared with non-users, the RR for PD was 0.79 (95% CI: 0.68–0.91). In a subgroup analysis of PD, this association was observed with medium and high quality, and the studies were adjusted for age, gender, and smoking status. When the data were stratified according to the duration of exposure, long-duration statin use was associated with a decreased risk of PD (RR = 0.49; 95% CI: 0.26–0.92). There was no significant decrease in the risk of PD in short-term statin users (RR = 0.94; 95% CI: 0.67–1.31). Moreover, no significant difference in the reduction in the risk of PD was observed between men (RR = 0.80; 95% CI: 0.75–0.86) and women (RR = 0.80; 95% CI: 0.75–0.86). Although our findings confirm a reduction in the PD risk associated with statin treatment and suggest that statins play a clinically favorable role, these findings should be interpreted with caution. Future randomized control trials with an ad hoc design are needed to confirm the potential utility of statins in reducing the risk of PD.
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