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01-09-2021 | Stroke | Systematic Review

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

Authors: Leah B. Kosyakovsky, Federico Angriman, Emma Katz, Neill K. Adhikari, Lucas C. Godoy, John C. Marshall, Bruno L. Ferreyro, Douglas S. Lee, Robert S. Rosenson, Naveed Sattar, Subodh Verma, Augustin Toma, Marina Englesakis, Barry Burstein, Michael E. Farkouh, Margaret Herridge, Dennis T. Ko, Damon C. Scales, Michael E. Detsky, Lior Bibas, Patrick R. Lawler

Published in: Intensive Care Medicine | Issue 9/2021

Abstract

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.

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Title: Association between sepsis survivorship and long-term cardiovascular outcomes in adults: a systematic review and meta-analysis
Authors: Leah B. Kosyakovsky
Federico Angriman
Emma Katz
Neill K. Adhikari
Lucas C. Godoy
John C. Marshall
Bruno L. Ferreyro
Douglas S. Lee
Robert S. Rosenson
Naveed Sattar
Subodh Verma
Augustin Toma
Marina Englesakis
Barry Burstein
Michael E. Farkouh
Margaret Herridge
Dennis T. Ko
Damon C. Scales
Michael E. Detsky
Lior Bibas
Patrick R. Lawler
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Septicemia
Septicemia
Myocardial Infarction
Heart Failure
Published in: Intensive Care Medicine / Issue 9/2021
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-021-06479-y

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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