Association between sepsis survivorship and long-term cardiovascular outcomes in adults: a systematic review and meta-analysis

被引：39

作者：

Kosyakovsky, Leah B. ^{[1
,2
]}

Angriman, Federico ^{[3
,4
,5
]}

Katz, Emma ^{[6
]}

Adhikari, Neill K. ^{[3
,4
,5
]}

Godoy, Lucas C. ^{[1
,4
,7
,8
]}

Marshall, John C. ^{[3
]}

Ferreyro, Bruno L. ^{[3
,9
,10
]}

Lee, Douglas S. ^{[7
,11
]}

Rosenson, Robert S. ^{[12
]}

Sattar, Naveed ^{[13
]}

Verma, Subodh ^{[14
]}

Toma, Augustin ^{[1
,2
]}

Englesakis, Marina ^{[15
]}

Burstein, Barry ^{[16
]}

Farkouh, Michael E. ^{[2
,16
]}

Herridge, Margaret ^{[3
]}

Ko, Dennis T. ^{[4
,7
,17
]}

Scales, Damon C. ^{[3
,4
,5
]}

Detsky, Michael E. ^{[3
,9
,10
]}

Bibas, Lior ^{[18
,19
]}

Lawler, Patrick R. ^{[1
,3
,11
]}

机构：

[1] Univ Hlth Network, Peter Munk Cardiac Ctr, RFE3-410,190 Elizabeth St, Toronto, ON, Canada

[2] Univ Toronto, Dept Med, Toronto, ON, Canada

[3] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[4] Univ Toronto, Dalla Lana Sch Publ Hlth, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[5] Sunnybrook Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON, Canada

[6] McGill Univ, Dept Med, Montreal, PQ, Canada

[7] ICES, Toronto, ON, Canada

[8] Univ Sao Paulo, Fac Med FMUSP, Inst Coracao InCor, Sao Paulo, Brazil

[9] Sinai Hlth Syst, Dept Med, Toronto, ON, Canada

[10] Univ Hlth Network, Toronto, ON, Canada

[11] Ted Rogers Ctr Heart Res, Toronto, ON, Canada

[12] Icahn Sch Med Mt Sinai, Mt Sinai Heart, Metab & Lipids Unit, New York, NY 10029 USA

[13] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland

[14] Univ Toronto, Keenan Res Ctr Biomed Sci, St Michaels Hosp, Toronto, ON, Canada

[15] Univ Hlth Network, Lib & Informat Serv, Toronto, ON, Canada

[16] Trillium Hlth Partners, Dept Cardiol, Mississauga, ON, Canada

[17] Sunnybrook Hlth Sci Ctr, Schulich Heart Ctr, Toronto, ON, Canada

[18] Hop Pierre Boucher, Dept Med, Longueuil, PQ, Canada

[19] Montreal Heart Inst, Dept Surg Intens Care, Montreal, PQ, Canada

来源：

INTENSIVE CARE MEDICINE | 2021年 / 47卷 / 09期

基金：

美国国家卫生研究院; 加拿大健康研究院;

关键词：

Sepsis; Cardiovascular outcomes; Myocardial infarction; Stroke; Heart failure; ONSET HEART-FAILURE; SEPTIC SHOCK; MORTALITY; RISK; HOSPITALIZATION; DISEASE; EVENTS; COMPLICATIONS; READMISSION; PNEUMONIA;

D O I：

10.1007/s00134-021-06479-y

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose We aimed to determine the association between sepsis and long-term cardiovascular events. Methods We conducted a systematic review of observational studies evaluating post-sepsis cardiovascular outcomes in adult sepsis survivors. MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception until April 21st, 2021. Two reviewers independently extracted individual study data and evaluated risk of bias. Random-effects models estimated the pooled crude cumulative incidence and adjusted hazard ratios (aHRs) of cardiovascular events compared to either non-septic hospital survivors or population controls. Primary outcomes included myocardial infarction, stroke, and congestive heart failure; outcomes were analysed at maximum reported follow-up (from 30 days to beyond 5 years post-discharge). Results Of 12,649 screened citations, 27 studies (25 cohort studies, 2 case-crossover studies) were included with a median of 4,289 (IQR 502-68,125) sepsis survivors and 18,399 (IQR 4,028-83,506) controls per study. The pooled cumulative incidence of myocardial infarction, stroke, and heart failure in sepsis survivors ranged from 3 to 9% at longest reported follow-up. Sepsis was associated with a higher long-term risk of myocardial infarction (aHR 1.77 [95% CI 1.26 to 2.48]; low certainty), stroke (aHR 1.67 [95% CI 1.37 to 2.05]; low certainty), and congestive heart failure (aHR 1.65 [95% CI 1.46 to 1.86]; very low certainty) compared to non-sepsis controls. Conclusions Surviving sepsis may be associated with a long-term, excess hazard of late cardiovascular events which may persist for at least 5 years following hospital discharge.

引用

页码：931 / 942

页数：12

共 73 条

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