METHODS: Published studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception-April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic.
RESULTS: Of the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both. The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12).
CONCLUSIONS: South Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported.
BACKGROUND: PROSPERO: CRD42021240865.
方法:已发表的关于发达国家南亚人和白人死亡率的研究从MEDLINE检索,PubMed,Embase,WebofScience,和灰色文献来源(开始至2021年4月),并使用“预后研究质量”工具进行严格评估。对主要和次要结局进行贝叶斯随机效应荟萃分析。使用I2统计量确定异质性。
结果:在最初筛选的9879项研究中,41人被认为是合格的。通过后来的搜索包括了另外3项研究。其中,15例报告的心血管疾病相关死亡率,23人报告了全因死亡率,和6报告两者。荟萃分析结果表明,与白人相比,南亚人心血管疾病死亡率的风险显着增加(风险比=1.32;95%可信区间=1.14至1.54),全因死亡率的风险降低(风险比=0.95;95%可信区间=0.83至1.12)。
结论:与白人相比,南亚人与心血管疾病相关的死亡率在统计学上明显更高,但不是全因死亡率。偏见的风险是一个严重的问题,主要是由于缺乏混杂因素的报道。
背景:PROSPERO:CRD42021240865。