Meta-regression analysis showed a trend in the proportion of DSS among DHF/DSS cases that gradually decreased over a period of 40 years, but the trend was not statically significant ( p = 0·089, Figure 2A ).
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Factors associated with dengue shock syndrome: a systematic review and meta-analysis.
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There were a decreasing trend of OR for AST over the recruitment year and publication year of studies; however, after removal of two earliest studies [60] , [61] , the effect of recruitment year and publication year on OR was lost, suggesting the two early studies overestimated the association with DSS.