Integrative literature review: Complications affecting allogeneic hematopoietic stem cell transplant patients after hospital discharge that may require the use of venous access

Description

Integrative literature review as an integral part of the phD thesis. Retrospective registration, performed after the search was conducted (the search was carried out in 2023). The research question for the review was: What complications affect allogeneic transplant recipients after hospital discharge that may require venous access? The search strategy used the PICo framework: “P” for population (transplant recipient); “I” for interest (complications requiring venous access); and “Co” for context (after hospital discharge/outpatient care). The descriptors (DeCS and MeSH) and keywords were determined based on this framework. The search was conducted using the Boolean operator “OR” between terms within the same group and “AND” between the groups (“P” AND “I” AND “Co”). The following databases were searched: the Virtual Health Library (VHL), maintained by the Latin American and Caribbean Center on Health Sciences Information (BIREME); MEDLINE/PubMed, via the National Library of Medicine; and Excerpta Medica Database (EMBASE). All full-text articles identified that contained evidence of predictive factors for complications in patients after allo-HSCT, until the year 2022, were included. Exclusion criteria were articles in which allo-HSCT was not the central topic, gray literature, and texts not written in English or Romance languages. During the review, scientific evidence regarding the risk of complications in transplant recipients was highlighted and grouped according to similarities. Searches in the VHL, PubMed, and Embase databases were conducted on March 27, 2023. The database search identified 1,977 records. After title and abstract screening and application of the eligibility criteria, 585 records remained. Following removal of 155 duplicates and 115 reports that could not be retrieved in full text, 315 full-text reports were assessed for eligibility. Of these, 48 were excluded because they did not address the review question, resulting in 267 studies included in the evidence synthesis. A table was developed containing each identified complication-related piece of evidence, the most common time of occurrence, treatment duration, risk factors, causes, required care, and prevalence. Sixty categories of complications were identified. These were summarized into the following groups: infectious complications; graft-versus-host disease (GVHD); organ dysfunction; nutritional complications; electrolyte disorders; functional capacity; psychosocial changes; late complications; hospital care; and disease relapse.

Institutions

• Universidade Federal do Rio de Janeiro

  Rio de Janeiro, Rio de Janeiro

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