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Does Hemoperfusion in Combination With Other Treatments Reduce the Mortality of Patients With Paraquat Poisoning More Than Hemoperfusion Alone: A Systematic Review With Meta-Analysis Publisher



Isfahani SN1 ; Farajzadegan Z2 ; Sabzghabaee A1 ; Rahimi A3 ; Samasamshariat S4 ; Eizadimood N5
Authors
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Authors Affiliations
  1. 1. Department of Clinical Toxicology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Social Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Management and Medical Information Sciences, Health Information Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Clinical Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2019


Abstract

Background: Paraquat (PQ) poisoning is a serious public health problem in many countries. In spite of different treatments, the mortality is still high. We performed a meta-Analysis to see whether hemoperfusion (HP) in combination with other treatments reduces the mortality more than HP alone in patients with PQ poisoning. Materials and Methods: We searched EMBASE, PubMed, Google Scholar, ISI Web of Knowledge, Cochrane Central Register of Controlled Trials, Scopus, Springer, TRIP, ProQuest, and references of the included studies from January 2000 to August 2017. Two reviewers independently searched and extracted data. We measured I 2 to determine variance contributed by heterogeneity. To investigate the publication bias, Begg's and Egger's tests were used along with funnel plot analysis. Results: Ultimately 12 articles were included in the meta-Analysis. Five articles compared HP with conventional therapy with a total of 1311 patients, and seven articles compared mortality of patients received HP versus those received HP in combination with an additional treatment. HP alone reduced the odds of death (odds ratio [OR] = 0.20; 95% confidence interval [CI]: 0.11-0.40, P < 0.0001) compared to conventional therapy. Furthermore, the odds of death was higher in HP group compared to those received HP in combination of additional treatments (OR = 1.24; 95% CI: 1.05-1.46, P= 0.01). Conclusion: The mortality was less in HP-Treated group compared to those received only conventional therapy. Addition of other treatments with HP reduced the mortality more than HP alone. © 2019 Journal of Research in Medical Sciences | Published by Wolters Kluwer - Medknow.
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