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Years of Life Lost (Yll) Due to Substance Abuse in Iran, in 2014-2017: Global Burden of Disease 2010 Method



Shahbazi F1 ; Mirtorabi D2 ; Ghadirzadeh MR3 ; Shojaei A3 ; Hashemi Nazari SS4
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
  2. 2. Department of Neurosciences and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
  4. 4. Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Public Health Published:2020

Abstract

Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016. Citations meeting inclusion criteria were full screened, and trial available data were abstracted independently and the Cochrane risk of bias tool was used for quality assessment. Results: Sixteen RCTs involving 2568 patients were subjected to this meta-analysis. The use of a Dex sedative regimen was associated with a reduce delirium prevalence [odd ratio (OR):0.33, 95% confidence intervals (CI): 0.24–0.45, I2= 5%, P<0.001], a shorter the length of ICU stay [mean difference (MD):-0.60, 95%CI:-0.69 to-0.50, I2=40%, P<0.001] and the length of hospital stay [MD:-0.68, 95%CI:-1.21 to-0.16, I2 =0%, P=0.01]. However, using of Dex could not shorter the duration of mechanical ventilation [MD:-10.18. 95%CI:-31.08–10.72, I2=99%, P=0.34], but could shorter the time to extubation in post-surgery patients [MD:-47.46, 95%CI:-84.63– 10.67, I2=98%, P=0.01]. Conclusion: The use of a Dex sedative regimen was associated with a reduce delirium prevalence, a shorter the length of ICU and hospital stay, and a shorter time to extubation in post-surgery critical ill patients. © 2020, Iranian Journal of Public Health. All rights reserved.