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Article ; Online: Frailty in acute coronary syndromes. A systematic review and narrative synthesis of frailty assessment tools and interventions from randomised controlled trials.

Chad, Thomas / Koulouroudias, Marinos / Layton, Georgia R / Fashina, Oluwatomini / Sze, Shirley / Roman, Marius / Murphy, Gavin J

International journal of cardiology

2024 Volume 399, Page(s) 131764

Abstract: Aim: We aimed to review all randomised controlled trial (RCT) data to explore optimal identification and treatment strategies of frail patients with Acute Coronary Syndromes (ACS).: Methods: The protocol was preregistered (PROSPERO - CRD42021250235). ...

Abstract	Aim: We aimed to review all randomised controlled trial (RCT) data to explore optimal identification and treatment strategies of frail patients with Acute Coronary Syndromes (ACS). Methods: The protocol was preregistered (PROSPERO - CRD42021250235). We performed a systematic review including RCT's that 1; used at least one frailty assessment tool to assess frailty and its impact on outcomes in patients diagnosed with ACS and 2; used at least one intervention where change in frailty was measured in patients diagnosed with ACS. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched on the 1st April 2021 and updated on 4th July 2023. Owing to low search output results are presented as a narrative synthesis of available evidence. Results: A single RCT used a frailty assessment tool. A single RCT specifically targeted frailty with their intervention. This precluded further quantitative analysis. There was indication of selection bias against frail participants, and a signal of value for physical activity measurement in frail ACS patients. There was a high level of uncertainty and low level of robustness of this evidence. Conclusions: Data from RCT's alone is inadequate in answering the reviews question. Future RCT's need to address ways to incorporate frail participants, whilst mitigating selection biases. Physical performance aspects of the frailty syndrome appear to be high yield modifiable targets that improve outcomes. Intervention trials should consider using change in frailty status as an outcome measure. Any trials that include frail participants should present data specifically attributable to this group.
MeSH term(s)	Humans ; Frailty/diagnosis ; Frailty/therapy ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/therapy ; Outcome Assessment, Health Care ; Research Design ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2024-01-09
Publishing country	Netherlands
Document type	Systematic Review ; Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2024.131764
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Zs.A 1673: Show issues

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Article ; Online: The Role of Preservation Solutions upon Saphenous Vein Endothelial Integrity and Function: Systematic Review and UK Practice Survey.

Layton, Georgia R / Ladak, Shameem S / Abbasciano, Riccardo / McQueen, Liam W / George, Sarah J / Murphy, Gavin J / Zakkar, Mustafa

Cells

2023 Volume 12, Issue 5

Abstract: The long saphenous vein is the most used conduit in cardiac surgery, but its long-term patency is limited by vein graft disease (VGD). Endothelial dysfunction is a key driver of VGD; its aetiology is multi-factorial. However emerging evidence identifies ... ...

Abstract	The long saphenous vein is the most used conduit in cardiac surgery, but its long-term patency is limited by vein graft disease (VGD). Endothelial dysfunction is a key driver of VGD; its aetiology is multi-factorial. However emerging evidence identifies vein conduit harvest technique and preservation fluids as causal in their onset and propagation. This study aims to comprehensively review published data on the relationship between preservation solutions, endothelial cell integrity and function, and VGD in human saphenous veins harvested for CABG. The review was registered with PROSPERO (CRD42022358828). Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases were undertaken from inception until August 2022. Papers were evaluated in line with registered inclusion and exclusion criteria. Searches identified 13 prospective, controlled studies for inclusion in the analysis. All studies used saline as a control solution. Intervention solutions included heparinised whole blood and saline, DuraGraft, TiProtec, EuroCollins, University of Wisconsin (UoW), buffered, cardioplegic and Pyruvate solutions. Most studies demonstrated that normal saline appears to have negative effects on venous endothelium and the most effective preservation solutions identified in this review were TiProtec and DuraGraft. The most used preservation solutions in the UK are heparinised saline or autologous whole blood. There is substantial heterogeneity both in practice and reporting of trials evaluating vein graft preservation solutions, and the quality of existing evidence is low. There is an unmet need for high quality trials evaluating the potential for these interventions to improve long-term patency in venous bypass grafts.
MeSH term(s)	Humans ; Saphenous Vein/transplantation ; Organ Preservation Solutions ; Prospective Studies ; Endothelium, Vascular ; Vascular Diseases ; United Kingdom
Chemical Substances	Organ Preservation Solutions
Language	English
Publishing date	2023-03-06
Publishing country	Switzerland
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells12050815
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Article ; Online: Osteopontin Activation and Microcalcification in Venous Grafts Can Be Modulated by Dexamethasone.

McQueen, Liam W / Ladak, Shameem S / Layton, Georgia R / Wadey, Kerry / George, Sarah J / Angelini, Gianni D / Murphy, Gavin J / Zakkar, Mustafa

Cells

2023 Volume 12, Issue 22

Abstract: Background: Osteopontin has been implicated in vascular calcification formation and vein graft intimal hyperplasia, and its expression can be triggered by pro-inflammatory activation of cells. The role of osteopontin and the temporal formation of ... ...

Abstract	Background: Osteopontin has been implicated in vascular calcification formation and vein graft intimal hyperplasia, and its expression can be triggered by pro-inflammatory activation of cells. The role of osteopontin and the temporal formation of microcalcification in vein grafts is poorly understood with a lack of understanding of the interaction between haemodynamic changes and the activation of osteopontin. Methods: We used a porcine model of vein interposition grafts, and human long saphenous veins exposed to ex vivo perfusion, to study the activation of osteopontin using polymerase chain reaction, immunostaining, and Results: The porcine model showed that osteopontin is active in grafts within 1 week following surgery and demonstrated the presence of microcalcification. A brief pretreatment of long saphenous veins with dexamethasone can suppress osteopontin activation. Prolonged culture of veins after exposure to acute arterial haemodynamics resulted in the formation of microcalcification but this was suppressed by pretreatment with dexamethasone. Conclusions: Osteopontin is activated in vein grafts and is associated with microcalcification formation. A brief pretreatment of veins ex vivo with dexamethasone can suppress its activation and associated microcalcification.
MeSH term(s)	Humans ; Swine ; Animals ; Osteopontin/metabolism ; Sodium Fluoride ; Saphenous Vein/transplantation ; Dexamethasone/pharmacology ; Calcinosis/metabolism
Chemical Substances	Osteopontin (106441-73-0) ; Sodium Fluoride (8ZYQ1474W7) ; Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2023-11-15
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells12222627
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Article: The Effectiveness of a Foundation Year 1 Doctor Preparation Course for Final Year Medical Students.

Beedham, William / Wanigasooriya, Kasun / Layton, Georgia R / Taing Chan, Ley / Darr, Adnan / Mittapalli, Devender

Journal of medical education and curricular development

2021 Volume 8, Page(s) 2382120520984184

Abstract: Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training.: Objectives: To evaluate the effectiveness of a novel ...

Abstract	Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled 'Preparation 2 Practice' delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2798123-X
ISSN	2382-1205
ISSN	2382-1205
DOI	10.1177/2382120520984184
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Article ; Online: The Role of Endothelial Cells in the Onset, Development and Modulation of Vein Graft Disease.

Ladak, Shameem S / McQueen, Liam W / Layton, Georgia R / Aujla, Hardeep / Adebayo, Adewale / Zakkar, Mustafa

Cells

2022 Volume 11, Issue 19

Abstract: Endothelial cells comprise the intimal layer of the vasculature, playing a crucial role in facilitating and regulating aspects such nutrient transport, vascular homeostasis, and inflammatory response. Given the importance of these cells in maintaining a ... ...

Abstract	Endothelial cells comprise the intimal layer of the vasculature, playing a crucial role in facilitating and regulating aspects such nutrient transport, vascular homeostasis, and inflammatory response. Given the importance of these cells in maintaining a healthy haemodynamic environment, dysfunction of the endothelium is central to a host of vascular diseases and is a key predictor of cardiovascular risk. Of note, endothelial dysfunction is believed to be a key driver for vein graft disease-a pathology in which vein grafts utilised in coronary artery bypass graft surgery develop intimal hyperplasia and accelerated atherosclerosis, resulting in poor long-term patency rates. Activation and denudation of the endothelium following surgical trauma and implantation of the graft encourage a host of immune, inflammatory, and cellular differentiation responses that risk driving the graft to failure. This review aims to provide an overview of the current working knowledge regarding the role of endothelial cells in the onset, development, and modulation of vein graft disease, as well as addressing current surgical and medical management approaches which aim to beneficially modulate endothelial function and improve patient outcomes.
MeSH term(s)	Endothelial Cells/pathology ; Endothelium, Vascular/pathology ; Humans ; Hyperplasia/pathology ; Tunica Intima/pathology ; Vascular Diseases/pathology
Language	English
Publishing date	2022-09-29
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells11193066
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Article: Unligated vertical vein presenting as a large atrio-portal shunt in adulthood: a case report.

Layton, Georgia R / Koulouroudias, Marinos / Issa, Eyad / Jepson, Steve / Corno, Antonio F / Dennison, Ashley R

Journal of surgical case reports

2020 Volume 2020, Issue 10, Page(s) rjaa377

Abstract: A 28-year-old male with infra-cardiac totally anomalous pulmonary venous connection (TAPVC) repaired as new-born presented in adulthood with right heart strain and very large left atrium to portal vein vessel. Residual connections from pulmonary veins to ...

Abstract	A 28-year-old male with infra-cardiac totally anomalous pulmonary venous connection (TAPVC) repaired as new-born presented in adulthood with right heart strain and very large left atrium to portal vein vessel. Residual connections from pulmonary veins to systemic circulation are believed to represent persistent 'vertical veins' (VV) not ligated at the time of the initial surgery. In our patient, since endovascular occlusion was not judged suitable, the anomalous vessel was surgically ligated and resected. A review of the literature failed to find such a procedure reported in an adult patient and analyzed the intra-operative ligation of VV during repair of TAPVC.
Language	English
Publishing date	2020-10-17
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjaa377
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Article ; Online: Challenges and outcomes for bariatric surgery in patients with paraplegia: Case series and systematic review.

Layton, Georgia R / Bhanderi, Shivam / Sahloul, Mohamed / Charalampakis, Vasileios / Daskalakis, Markos / Singhal, Rishi

Clinical obesity

2020 Volume 10, Issue 4, Page(s) e12382

Abstract: Introduction: Obesity contributes to a plethora of significant chronic diseases. Bariatric surgery has been demonstrated to be the most cost-effective treatment for severe obesity and significantly reduces morbidity and mortality from metabolic syndrome. ...

Abstract	Introduction: Obesity contributes to a plethora of significant chronic diseases. Bariatric surgery has been demonstrated to be the most cost-effective treatment for severe obesity and significantly reduces morbidity and mortality from metabolic syndrome. Patients with paraplegia have significantly impaired mobility and are therefore at a much higher risk of developing severe obesity and its sequelae. Bariatric surgery may bring significant improvements to mobility, morbidity and quality of life for patients with paraplegia, but evidence in the literature is poor for this group of patients. Methods: A systematic review was conducted conforming to PRISMA guidelines. The MEDLINE and Cochrane databases were searched for all articles published prior to April 2019 matching all of the keywords 'bariatric', 'paraplegia' and 'spinal cord'. Articles were assessed for relevance and full texts reviewed. In addition, clinical records were reviewed for three patients who underwent bariatric surgery at a single UK private institution. Non-identifiable demographic, clinical, operative and outcome data were obtained from electronic records. Results: Twenty seven articles were retrieved from the initial database search, of which nine eligible full texts were reviewed. Eight articles were case reports or case series and the final article was a systematic review. All cases reported had positive outcomes with significant weight loss, improvement in mobility and increased quality of life. Outcomes from the three diversely aged patients in our case series were similarly positive, with no significant post-operative complications. Discussion: Patients with obesity and paraplegia may significantly benefit from bariatric surgery. There is a need for multi-centre cohort studies to evaluate outcomes and the choice of bariatric intervention. UK guidelines do not include criteria based on mobility or neurological deficit, resulting in a potential missed opportunity to offer a cost-effective treatment that can significantly improve quality of life for patients with severe obesity and paraplegia.
MeSH term(s)	Adult ; Bariatric Surgery ; Female ; Humans ; Middle Aged ; Obesity/complications ; Obesity/surgery ; Paraplegia/complications ; Postoperative Complications ; Quality of Life ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2020-06-07
Publishing country	England
Document type	Case Reports ; Journal Article ; Systematic Review
ZDB-ID	2625816-X
ISSN	1758-8111 ; 1758-8103
ISSN (online)	1758-8111
ISSN	1758-8103
DOI	10.1111/cob.12382
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Article ; Online: Trends and outcomes of concomitant aortic valve replacement and coronary artery bypass grafting in the UK and a survey of practices.

Fudulu, Daniel P / Layton, Georgia R / Nguyen, Bao / Sinha, Shubhra / Dimagli, Arnaldo / Guida, Gustavo / Abbasciano, Riccardo / Viviano, Alessandro / Angelini, Gianni D / Zakkar, Mustafa

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2023 Volume 64, Issue 4

Abstract: Objectives: Concomitant revascularization of coronary artery disease at the same time as treatment for aortic valvopathy favourably impacts survival. However, combined surgery may be associated with increased adverse outcomes compared to aortic valve ... ...

Abstract	Objectives: Concomitant revascularization of coronary artery disease at the same time as treatment for aortic valvopathy favourably impacts survival. However, combined surgery may be associated with increased adverse outcomes compared to aortic valve replacement (AVR) or coronary artery bypass grafting in isolation. Methods: We retrospectively analyzed all patients who underwent AVR with bypass grafting between February 1996 and March 2019 using data from the National Adult Cardiac Surgery Audit. We used a generalized mixed-effects model to assess the effect of the number and type of bypass grafts associated with surgical AVR on in-hospital mortality, postoperative stroke, and the need for renal dialysis. Furthermore, we conducted an international cross-sectional survey of cardiac surgeons to explore their views about concomitant AVR with coronary bypass grafting interventions. Results: Fifty-one thousand two hundred and seventy-two patients were included in the study. Patients receiving 2 or more bypass grafts demonstrated more significant preoperative comorbidity and disease severity. Patients undergoing 2 and >2 grafts in addition to AVR had increased mortality as compared to patients undergoing AVR and only 1 graft [odds ratio (OR) 1.17, 95% confidence interval (CI) [1.05-1.30], P = 0.005 and OR 1.15, 95% CI [1.02-1.30], P = 0.024 respectively]. A single arterial conduit was associated with a reduction in mortality (OR 0.75, 95% CI [0.68-0.82], P < 0.001) and postoperative dialysis (OR 0.87, 95% CI [0.78-0.96], P = 0.006), but this association was lost with >1 arterial conduit. One hundred and three surgeons responded to our survey, with only a small majority believing that the number of bypass grafts can influence short- or long-term postoperative outcomes in these patients, and an almost equal split in responders supporting the use of staged or hybrid interventions for patients with concomitant pathology. Conclusions: The number of grafts performed during combined AVR and coronary artery bypass grafting is associated with increased morbidity and mortality. The use of an arterial graft was also associated with reduced mortality. Future studies are needed to assess the effect of incomplete revascularization and measure long-term outcomes. Based on our data, current published evidence, and the collective expert opinion we gathered, we endorse future work to investigate the short and long-term efficacy and safety of hybrid intervention for patients with concomitant advanced coronary and aortic valve disease.
MeSH term(s)	Adult ; Humans ; Aortic Valve/surgery ; Retrospective Studies ; Cross-Sectional Studies ; Heart Valve Prosthesis Implantation/adverse effects ; Treatment Outcome ; Coronary Artery Bypass/adverse effects ; Aortic Valve Stenosis/surgery ; United Kingdom/epidemiology ; Risk Factors ; Postoperative Complications/etiology
Language	English
Publishing date	2023-07-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezad259
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Zs.A 2303: Show issues

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Article ; Online: Impact of COVID-19, gender, race, specialty and seniority on mental health during surgical training: an international study.

Kovoor, Joshua G / Layton, Georgia R / Burke, Joshua R / Churchill, James A / Jacobsen, Jonathan Henry W / Reid, Jessica L / Edwards, Suzanne / Issa, Eyad / Garrod, Tamsin J / Archer, Julian / Tivey, David R / Babidge, Wendy J / Dennison, Ashley R / Maddern, Guy J

ANZ journal of surgery

2022 Volume 92, Issue 9, Page(s) 2094–2101

Abstract: Background: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross-sectional study determining relative impacts of COVID-19, gender, race, specialty and seniority on mental ... ...

Abstract	Background: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross-sectional study determining relative impacts of COVID-19, gender, race, specialty and seniority on mental health of surgical trainees. Method: Trainees across Australia, New Zealand and UK enrolled in surgical training accredited by the Royal Australasian College of Surgeons or Royal College of Surgeons were included. Outcomes included the short version of the Perceived Stress Scale, Oxford Happiness Questionnaire short scale, Patient Health Questionnaire-2 and the effect on individual stress levels of training experiences affected by COVID-19. Predictors included trainee characteristics and local COVID-19 prevalence. Multivariable linear regression analyses were conducted to assess association between outcomes and predictors. Results: Two hundred and five surgical trainees were included. Increased stress was associated with number of COVID-19 patients treated (P = 0.0127), female gender (P = 0.0293), minority race (P = 0.0012), less seniority (P = 0.001), and greater COVID-19 prevalence (P = 0.0122). Lower happiness was associated with training country (P = 0.0026), minority race (P = 0.0258) and more seniority (P < 0.0001). Greater depression was associated with more seniority (P < 0.0001). Greater COVID-19 prevalence was associated with greater reported loss of training opportunities (P = 0.0038), poor working conditions (P = 0.0079), personal protective equipment availability (P = 0.0008), relocation to areas of little experience (P < 0.0001), difficulties with career progression (P = 0.0172), loss of supervision (P = 0.0211), difficulties with pay (P = 0.0034), and difficulties with leave (P = 0.0002). Conclusion: This is the first study to specifically describe the relative impacts of COVID-19 community prevalence, gender, race, surgical specialty and level of seniority on stress, happiness and depression of surgical trainees on an international scale.
MeSH term(s)	COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Mental Health ; Prospective Studies ; Specialties, Surgical/education
Language	English
Publishing date	2022-08-18
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.17980
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Zs.A 180: Show issues

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Article ; Online: Activation of the innate immune response and organ injury after cardiac surgery: a systematic review and meta-analysis of randomised trials and analysis of individual patient data from randomised and non-randomised studies.

Abbasciano, Riccardo G / Lai, Florence Y / Roman, Marius A / Rizzello, Angelica / Pathak, Suraj / Ramzi, Joussi / Lucarelli, Carla / Layton, Georgia R / Kumar, Tracy / Wozniak, Marcin J / Eagle-Hemming, Bryony / Akowuah, Enoch / Rogers, Chris A / Angelini, Gianni D / Murphy, Gavin J

British journal of anaesthesia

2021 Volume 127, Issue 3, Page(s) 365–375

Abstract: Background: It is unclear whether the innate immune response represents a therapeutic target for organ protection strategies in cardiac surgery.: Methods: A systematic review of trials of interventions targeting the inflammatory response to cardiac ... ...

Abstract	Background: It is unclear whether the innate immune response represents a therapeutic target for organ protection strategies in cardiac surgery. Methods: A systematic review of trials of interventions targeting the inflammatory response to cardiac surgery reporting treatment effects on both innate immune system cytokines and organ injury was performed. The protocol was registered at the International Prospective Register of Systematic Reviews: CRD42020187239. Searches of the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase were performed. Random-effects meta-analyses were used for the primary analysis. A separate analysis of individual patient data from six studies (n=785) explored sources of heterogeneity for treatment effects on cytokine levels. Results: Searches to May 2020 identified 251 trials evaluating 24 interventions with 20 582 participants for inclusion. Most trials had important limitations. Methodological limitations of the included trials and heterogeneity of the treatment effects on cytokine levels between trials limited interpretation. The primary analysis demonstrated inconsistency in the direction of the treatment effects on innate immunity and organ failure or death between interventions. Analyses restricted to important subgroups or trials with fewer limitations showed similar results. Meta-regression, pooling available data from all trials, demonstrated no association between the direction of the treatment effects on inflammatory cytokines and organ injury or death. The analysis of individual patient data demonstrated heterogeneity in the association between the cytokine response and organ injury after cardiac surgery for people >75 yr old and those with some chronic diseases. Conclusions: The certainty of the evidence for a causal relationship between innate immune system activation and organ injury after cardiac surgery is low.
MeSH term(s)	Aged ; Aged, 80 and over ; Anti-Inflammatory Agents/therapeutic use ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/mortality ; Cytokines/blood ; Cytokines/immunology ; Female ; Humans ; Immunity, Innate/drug effects ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Risk Assessment ; Risk Factors ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/immunology ; Systemic Inflammatory Response Syndrome/mortality ; Systemic Inflammatory Response Syndrome/prevention & control ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents ; Cytokines
Language	English
Publishing date	2021-07-03
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.04.032
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