. 2022 Dec 1;12(12):e063023. doi: 10.1136/bmjopen-2022-063023

Table 2.

Summary of findings for prognostic factor—outcome meta-analyses

Prognostic factor	No of patients (studies)	OR (95% CI)	Absolute effect estimates		GRADE: certainty of the evidence
Prognostic factor	No of patients (studies)	OR (95% CI)	Risk without prognostic factor	Risk with prognostic factor	GRADE: certainty of the evidence
Mortality
Demographic
Male versus female	80 (13)	0.95 (0.36 to 2.52)	250 per 1000	241 per 1000	Very low
Male versus female	80 (13)	0.95 (0.36 to 2.52)	−9 (−143 to 207)		Due to very serious risk of bias and imprecision
<18 vs 18–64 years	694 (5)	0.54 (0.15 to 1.94)	234 per 1000	142 per 1000	Very low
<18 vs 18–64 years	694 (5)	0.54 (0.15 to 1.94)	−92 (−190 to 138)		Due to very serious risk of bias and imprecision, and serious inconsistency
≥65 vs <18 years	136 (2)	10.66 (1.28 to 88.57)*	50 per 1000	359 per 1000	Very low
≥65 vs <18 years	136 (2)	10.66 (1.28 to 88.57)*	309 (13 to 773)		Due to very serious risk of bias and serious imprecision
≥65 vs 18−64 years	396 (2)	2.37 (1.47 to 3.84)*	193 per 1000	362 per 1000	Low
≥65 vs 18−64 years	396 (2)	2.37 (1.47 to 3.84)*	169 (67 to 286)		Due to very serious risk of bias
Medical history
Immunocompromised versus not Immunocompromised	33 (4)	1.65 (0.33 to 8.26)	438 per 1000	563 per 1000	Very low
Immunocompromised versus not Immunocompromised	33 (4)	1.65 (0.33 to 8.26)	125 (−233 to 428)		Due to very serious risk of bias and imprecision
Early disease
Acute renal failure versus no acute renal failure	91 (4)	2.50 (0.97 to 6.42)	NA per 1000	NA per 1000	Very low
Acute renal failure versus no acute renal failure	91 (4)	2.50 (0.97 to 6.42)	140 (−60 to 330)		Due to very serious risk of bias and imprecision
Necrotising fasciitis versus no necrotising fasciitis	840 (10)	0.81 (0.51 to 1.29)	347 per 1000	301 per 1000	Very low
Necrotising fasciitis versus no necrotising fasciitis	840 (10)	0.81 (0.51 to 1.29)	−46 (−134 to 60)		Due to very serious risk of bias and imprecision
Treatment
IVIG versus no IVIG (all STSS patients)	365 (9)	0.37 (0.17 to 0.80)*	231 per 1000	100 per 1000	Very low
IVIG versus no IVIG (all STSS patients)	365 (9)	0.37 (0.17 to 0.80)*	−131 (−182 to −37)		Due to very serious risk of bias and serious imprecision
IVIG versus no IVIG (subset of STSS patients treated with clindamycin)	188 (6)	0.34 (0.15 to 0.75)*	300 per 1000	127 per 1000	Low
	188 (6)	0.34 (0.15 to 0.75)*	−173 (−240 to −57)		Due to serious risk of bias and imprecision
Any antibiotic versus no antibiotic	19 (3)	0.48 (0.05 to 4.76)	NA per 1000	NA per 1000	Very low
Any antibiotic versus no antibiotic	19 (3)	0.48 (0.05 to 4.76)	−120 (−490 to 260)		Due to very serious risk of bias and imprecision
Clindamycin versus no clindamycin antibiotic	144 (4)	0.14 (0.06 to 0.37)*	800 per 1000	359 per 1000	Low
Clindamycin versus no clindamycin antibiotic	144 (4)	0.14 (0.06 to 0.37)*	−441 (−606 to −203)		Due to serious risk of bias and imprecision
Haemodialysis versus no haemodialysis	42 (4)	1.94 (0.22 to 16.99)	107 per 1000	189 per 1000	Very low
Haemodialysis versus no haemodialysis	42 (4)	1.94 (0.22 to 16.99)	82 (−81 to 564)		Due to very serious risk of bias and imprecision
NSAIDs vs no NSAIDs	50 (4)	4.14 (1.13 to 15.14)*	100 per 1000	315 per 1000	Very low
NSAIDs vs no NSAIDs	50 (4)	4.14 (1.13 to 15.14)*	215 (12 to 527)		Due to very serious risk of bias and serious imprecision
ICU admission
Demographic
Male vs female	19 (3)	2.87 (0.29 to 28.27)	NA per 1000	NA per 1000	Very low
Male vs female	19 (3)	2.87 (0.29 to 28.27)	150 (−160 to 450)		Due to very serious risk of bias and imprecision
Early disease
Necrotising fasciitis vs no necrotising fasciitis	28 (3)	0.74 (0.12 to 4.48)	900 per 1000	869 per 1000	Very low
Necrotising fasciitis vs no necrotising fasciitis	28 (3)	0.74 (0.12 to 4.48)	−31 (−381 to 76)		Due to very serious risk of bias and imprecision
Treatment
IVIG versus no IVIG (all STSS patients)	156 (3)	1.09 (0.43 to 2.77)	833 per 1000	845 per 1000	Very low
IVIG versus no IVIG (all STSS patients)	156 (3)	1.09 (0.43 to 2.77)	12 (−151 to 100)		Due to very serious risk of bias and imprecision
Any antibiotic versus no antibiotic	14 (2)	4.60 (0.29 to 72.89)	500 per 1000	821 per 1000	Very low
Any antibiotic versus no antibiotic	14 (2)	4.60 (0.29 to 72.89)	321 (−275 to 486)		Due to very serious risk of bias and imprecision
Haemodialysis versus no haemodialysis	13 (2)	3.25 (0.21 to 50.35)	875 per 1000	958 per 1000	Very low
Haemodialysis versus no haemodialysis	13 (2)	3.25 (0.21 to 50.35)	83 (−280 to 122)		Due to very serious risk of bias and imprecision
NSAIDs versus no NSAIDs	15 (2)	0.86 (0.06 to 12.48)	NA per 1000	NA per 1000	Very low
NSAIDs versus no NSAIDs	15 (2)	0.86 (0.06 to 12.48)	−10 (−430 to 400)		Due to very serious risk of bias and imprecision
Clinical cure or improvement
Demographic
Male versus female	23 (4)	3.33 (0.47 to 23.59)	875 per 1000	959 per 1000	Very low
Male versus female	23 (4)	3.33 (0.47 to 23.59)	84 (−108 to 119)		Due to very serious risk of bias and imprecision
Early disease
Necrotising fasciitis versus no necrotising fasciitis	24 (2)	0.34 (0.02 to 5.20)	950 per 1000	866 per 1000	Very low
Necrotising fasciitis versus no necrotising fasciitis	24 (2)	0.34 (0.02 to 5.20)	−84 (−675 to 40)		Due to very serious risk of bias and serious imprecision
Treatment
IVIG versus no IVIG (in all STSS patients)	23 (2)	0.27 (0.02 to 3.76)	NA per 1000	NA per 1000	Very low
IVIG versus no IVIG (in all STSS patients)	23 (2)	0.27 (0.02 to 3.76)	−100 (−350 to 140)		Due to very serious risk of bias and imprecision
Haemodialysis versus no haemodialysis	26 (3)	1.43 (0.15 to 14.08)	NA per 1000	NA per 1000	Very low
Haemodialysis versus no haemodialysis	26 (3)	1.43 (0.15 to 14.08)	50 (−240 to 340)		Due to very serious risk of bias and imprecision
Need for mechanical ventilation
Demographic
Male versus female	21 (3)	2.09 (0.32 to 13.74)	NA per 1000	NA per 1000	Very low
Male versus female	21 (3)	2.09 (0.32 to 13.74)	120 (−200 to 440)		Due to very serious risk of bias and imprecision
Early disease
Acute renal failure versus no acute renal failure	20 (2)	1.14 (0.17 to 7.82)	750 per 1000	774 per 1000	Very low
Acute renal failure versus no acute renal failure	20 (2)	1.14 (0.17 to 7.82)	24 (−412 to 209)		Due to very serious risk of bias and imprecision
Necrotising fasciitis versus no necrotising fasciitis	31 (3)	3.75 (0.47 to 29.81)	700 per 1000	897 per 1000	Very low
Necrotising fasciitis versus no necrotising fasciitis	31 (3)	3.75 (0.47 to 29.81)	197 (−177 to 286)		Due to very serious risk of bias and imprecision
Treatment
IVIG versus no IVIG (in all STSS patients)	157 (3)	2.22 (0.78 to 6.32)	333 per 1000	526 per 1000	Very low
IVIG versus no IVIG (in all STSS patients)	157 (3)	2.22 (0.78 to 6.32)	193 (−53 to 426)		Due to very serious risk of bias and imprecision
Haemodialysis vs no haemodialysis	26 (3)	2.05 (0.39 to 10.70)	500 per 1000	672 per 1000	Very low
Haemodialysis vs no haemodialysis	26 (3)	2.05 (0.39 to 10.70)	172 (−219 to 415)		Due to very serious risk of bias and imprecision
Duration of hospitalisation
Treatment
IVIG versus no IVIG (all STSS patients)	201 (3)	NA	NA per 1000	NA per 1000	Low
IVIG versus no IVIG (all STSS patients)	201 (3)	NA	On average, 5.51 fewer days (17.64 fewer to 6.62 more)		Due to serious risk of bias and imprecision
Duration of ICU stay
Treatment
IVIG versus no IVIG (all STSS patients)	131 (2)	NA	NA per 1000	NA per 1000	Very low
IVIG versus no IVIG (all STSS patients)	131 (2)	NA	On average, 3.80 more days (3.62 fewer to 11.23 more)		Due to very serious risk of bias and serious imprecision

*Statistical evidence of an association.

GRADE, Grading of Recommendations, Assessment, Development and Evaluation; ICU, intensive care unit; NA, not available; NSAIDs, non-steroidal anti-inflammatory drugs; STSS, streptococcal toxic shock syndrome.