Cardiac dysfunction in patients affected by subarachnoid haemorrhage affects in-hospital mortality : A systematic review and metanalysis
Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited..
BACKGROUND: Subarachnoid haemorrhage (SAH) is a life-threatening condition with associated brain damage. Moreover, SAH is associated with a massive release of catecholamines, which may promote cardiac injury and dysfunction, possibly leading to haemodynamic instability, which in turn may influence a patient's outcome.
OBJECTIVES: To study the prevalence of cardiac dysfunction (as assessed by echocardiography) in patients with SAH and its effect on clinical outcomes.
DESIGN: Systematic review of observational studies.
DATA SOURCES: We performed a systematic search over the last 20 years on MEDLINE and EMBASE databases.
ELIGIBILITY CRITERIA: Studies reporting echocardiography findings in adult patients with SAH admitted to intensive care. Primary outcomes were in-hospital mortality and poor neurological outcome according to the presence or absence of cardiac dysfunction.
RESULTS: We included a total of 23 studies (4 retrospective) enrolling 3511 patients. The cumulative frequency of cardiac dysfunction was 21% (725 patients), reported as regional wall motion abnormality in the vast majority of studies (63%). Due to the heterogeneity of clinical outcome data reporting, a quantitative analysis was carried out only for in-hospital mortality. Cardiac dysfunction was associated with a higher in-hospital mortality [odds ratio 2.69 (1.64 to 4.41); P < 0.001; I2 = 63%]. The GRADE of evidence assessment resulted in very low certainty of evidence.
CONCLUSION: About one in five patients with SAH develops cardiac dysfunction, which seems to be associated with higher in-hospital mortality. The consistency of cardiac and neurological data reporting is lacking, reducing the comparability of the studies in this field.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
European journal of anaesthesiology - 40(2023), 6 vom: 01. Juni, Seite 442-449 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Messina, Antonio [VerfasserIn] |
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| Anmerkungen: |
Date Completed 04.05.2023 Date Revised 02.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/EJA.0000000000001829 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Messina, Antonio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cardiac dysfunction in patients affected by subarachnoid haemorrhage affects in-hospital mortality |b A systematic review and metanalysis |
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| 500 | |a Date Revised 02.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited. | ||
| 520 | |a BACKGROUND: Subarachnoid haemorrhage (SAH) is a life-threatening condition with associated brain damage. Moreover, SAH is associated with a massive release of catecholamines, which may promote cardiac injury and dysfunction, possibly leading to haemodynamic instability, which in turn may influence a patient's outcome | ||
| 520 | |a OBJECTIVES: To study the prevalence of cardiac dysfunction (as assessed by echocardiography) in patients with SAH and its effect on clinical outcomes | ||
| 520 | |a DESIGN: Systematic review of observational studies | ||
| 520 | |a DATA SOURCES: We performed a systematic search over the last 20 years on MEDLINE and EMBASE databases | ||
| 520 | |a ELIGIBILITY CRITERIA: Studies reporting echocardiography findings in adult patients with SAH admitted to intensive care. Primary outcomes were in-hospital mortality and poor neurological outcome according to the presence or absence of cardiac dysfunction | ||
| 520 | |a RESULTS: We included a total of 23 studies (4 retrospective) enrolling 3511 patients. The cumulative frequency of cardiac dysfunction was 21% (725 patients), reported as regional wall motion abnormality in the vast majority of studies (63%). Due to the heterogeneity of clinical outcome data reporting, a quantitative analysis was carried out only for in-hospital mortality. Cardiac dysfunction was associated with a higher in-hospital mortality [odds ratio 2.69 (1.64 to 4.41); P < 0.001; I2 = 63%]. The GRADE of evidence assessment resulted in very low certainty of evidence | ||
| 520 | |a CONCLUSION: About one in five patients with SAH develops cardiac dysfunction, which seems to be associated with higher in-hospital mortality. The consistency of cardiac and neurological data reporting is lacking, reducing the comparability of the studies in this field | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Longhitano, Yaroslava |e verfasserin |4 aut | |
| 700 | 1 | |a Zanza, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Calabrò, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Villa, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Cammarota, Gianmaria |e verfasserin |4 aut | |
| 700 | 1 | |a Sanfilippo, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Cecconi, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a Robba, Chiara |e verfasserin |4 aut | |
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