Long term risk of recurrence among survivors of sudden cardiac arrest: A systematic review and meta-analysis

被引:4
作者
Lam, Timothy Jia Rong [1 ]
Yang, Jacqueline [2 ]
Poh, Jane Elizabeth [2 ]
Ong, Marcus Eng Hock [3 ,4 ]
Liu, Nan [5 ]
Yeo, Jun Wei [1 ]
Grasner, Jan-Thorsten [6 ]
Masuda, Yoshio [1 ]
Ho, Andrew Fu Wah [3 ,5 ]
机构
[1] Natl Univ Singapore, Yong Loo Lin Sch Med, 10 Med Dr, Singapore 117597, Singapore
[2] Nanyang Technol Univ, Lee Kong Chian Sch Med, 59 Nanyang Dr,Expt Med Bldg, Singapore 636921, Singapore
[3] Singapore Gen Hosp, Dept Emergency Med, Outram Rd, Singapore 169608, Singapore
[4] Duke NUS Med Sch, Hlth Serv & Syst Res, Singapore, Singapore
[5] Duke NUS Med Sch, Prehosp & Emergency Res Ctr, Singapore, Singapore
[6] Univ Hosp Schleswig Holstein, Inst Emergency Med, Kiel, Germany
基金
英国医学研究理事会;
关键词
Sudden cardiac arrest; Out-of hospital; Recurrence; Meta-analysis; HOSPITAL VENTRICULAR-FIBRILLATION; FOLLOW-UP; PROGNOSIS; DEATH; RESUSCITATION; ARRHYTHMIAS; MANAGEMENT; STATEMENT; DIAGNOSIS; THERAPY;
D O I
10.1016/j.resuscitation.2022.04.027
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Aims: With a growing number of survivors of sudden cardiac arrest globally, their natural disease progression is of interest. This systematic review and meta-analysis aimed to determine the risk of recurrence after sudden cardiac arrest and its associated risk factors. Methods: Medline, Embase, Cochrane Library and Scopus were searched from inception to October 2021. Studies involving survivors of an out-of-hospital sudden cardiac arrest event of any non-traumatic aetiology were included. Meta-analyses of proportions using the random-effects model estimated the primary outcome of first recurrent sudden cardiac arrest incidence as well as secondary outcomes including cumulative incidence of recurrence at 1-year and incidence of second recurrence among survivors of first recurrence. A recurrent episode was defined as a sudden cardiac arrest that occurs 28 or more days after the index event. Subgroup and meta-regression analyses were conducted for predetermined variables. The Newcastle-Ottawa Scale was used to assess risk of bias for most studies. Results: 35 studies of moderate to high quality comprising a total of 7186 survivors were analysed. The pooled incidence of first recurrence was 15.24% (32 studies; 95%CI, 11.01-19.95; mean follow-up time, 41.3 +/- 29.3 months) and second recurrence was 35.03% (3 studies; 95%CI, 19.65-51.93; mean follow-up time, 161.1 +/- 54.3 months). At 1-year, incidence of recurrence was 10.62% (3 studies; 95%CI, 0.25-30.42). Subgroup analyses found no significant difference (p= 0.204) between incidence of first recurrence published from 1975-1992 and 1993-2021, and between studies with mean follow-up time of <24 months, 24-48 months, and >48 months. On meta-regression, initial shockable rhythm increased incidence of first recurrence (p = 0.01). Conclusion: 15.24% of sudden cardiac arrest survivors experienced a recurrence, and of these, 35.03% experienced a second recurrence. Most recurrences occurred in the first year. Initial shockable rhythm increased this risk. Despite the limitations of inter-study heterogeneity, these findings can still guide intervention and follow-up of sudden cardiac arrest survivors.
引用
收藏
页码:30 / 41
页数:12
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