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Cardiac dysfunction in patients affected by subarachnoid haemorrhage affects in-hospital mortality: A systematic review and metanalysis.
Messina, Antonio; Longhitano, Yaroslava; Zanza, Christian; Calabrò, Lorenzo; Villa, Federico; Cammarota, Gianmaria; Sanfilippo, Filippo; Cecconi, Maurizio; Robba, Chiara.
Afiliação
  • Messina A; From the IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (AM, LC, FV, MC), Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (AM, MC), Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA (YL, CZ), IRCCS Ospedale Policlinico San Martino (CR), Dipartimento di Medicina E Chirurgia, Universita' Degli Studi di Perugia, Perugia (GC) and Department of Anaesthesia and Intensive Care, A.O.U. 'Policli
Eur J Anaesthesiol ; 40(6): 442-449, 2023 06 01.
Article em En | MEDLINE | ID: mdl-37052065
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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemorragia Subaracnóidea / Cardiopatias Tipo de estudo: Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Adult / Humans Idioma: En Revista: Eur J Anaesthesiol Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemorragia Subaracnóidea / Cardiopatias Tipo de estudo: Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Adult / Humans Idioma: En Revista: Eur J Anaesthesiol Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2023 Tipo de documento: Article