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Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis

BACKGROUND: Long-term risk and predictors of cerebrovascular events following sepsis hospitalization have not been clearly elucidated. We aim to determine the association between surviving sepsis hospitalization and cerebrovascular complications in adult sepsis survivors. METHOD: We searched MEDLINE...

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Autores principales: Arero, Amanuel Godana, Vasheghani-Farahani, Ali, Tigabu, Bereket Molla, Arero, Godana, Ayene, Beniyam Yimam, Soltani, Danesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732021/
https://www.ncbi.nlm.nih.gov/pubmed/36507522
http://dx.doi.org/10.3389/fmed.2022.1065476
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author Arero, Amanuel Godana
Vasheghani-Farahani, Ali
Tigabu, Bereket Molla
Arero, Godana
Ayene, Beniyam Yimam
Soltani, Danesh
author_facet Arero, Amanuel Godana
Vasheghani-Farahani, Ali
Tigabu, Bereket Molla
Arero, Godana
Ayene, Beniyam Yimam
Soltani, Danesh
author_sort Arero, Amanuel Godana
collection PubMed
description BACKGROUND: Long-term risk and predictors of cerebrovascular events following sepsis hospitalization have not been clearly elucidated. We aim to determine the association between surviving sepsis hospitalization and cerebrovascular complications in adult sepsis survivors. METHOD: We searched MEDLINE, Embase, Scopus, Web of Sciences, Cochrane library, and Google scholar for studies published from the inception of each database until 31 August 2022. RESULTS: Of 8,601 screened citations, 12 observational studies involving 829,506 participants were analyzed. Surviving sepsis hospitalization was associated with a significantly higher ischemic stroke [adjusted hazard ratio (aHR) 1.45 (95% CI, 1.23–1.71), I(2) = 96], and hemorrhagic stroke [aHR 2.22 (95% CI, 1.11–4.42), I(2) = 96] at maximum follow-up compared to non-sepsis hospital or population control. The increased risk was robust to several sensitivity analyses. Factors that were significantly associated with increased hazards of stroke were: advanced age, male gender, diabetes mellitus, hypertension, coronary artery disease, chronic heart failure, chronic kidney disease, chronic obstruction pulmonary disease, and new-onset atrial fibrillation. Only diabetes mellites [aHR 1.80 (95% CI, 1.12–2.91)], hypertension [aHR 2.2 (95% CI, 2.03–2.52)], coronary artery disease [HR 1.64 (95% CI, 1.49–1.80)], and new-onset atrial fibrillation [aHR 1.80 (95% CI, 1.42–2.28)], were associated with > 50% increase in hazards. CONCLUSION: Our findings showed a significant association between sepsis and a subsequent risk of cerebrovascular events. The risk of cerebrovascular events can be predicated by patient and sepsis-related baseline variables. New therapeutic strategies are needed for the high-risk patients.
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spelling pubmed-97320212022-12-10 Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis Arero, Amanuel Godana Vasheghani-Farahani, Ali Tigabu, Bereket Molla Arero, Godana Ayene, Beniyam Yimam Soltani, Danesh Front Med (Lausanne) Medicine BACKGROUND: Long-term risk and predictors of cerebrovascular events following sepsis hospitalization have not been clearly elucidated. We aim to determine the association between surviving sepsis hospitalization and cerebrovascular complications in adult sepsis survivors. METHOD: We searched MEDLINE, Embase, Scopus, Web of Sciences, Cochrane library, and Google scholar for studies published from the inception of each database until 31 August 2022. RESULTS: Of 8,601 screened citations, 12 observational studies involving 829,506 participants were analyzed. Surviving sepsis hospitalization was associated with a significantly higher ischemic stroke [adjusted hazard ratio (aHR) 1.45 (95% CI, 1.23–1.71), I(2) = 96], and hemorrhagic stroke [aHR 2.22 (95% CI, 1.11–4.42), I(2) = 96] at maximum follow-up compared to non-sepsis hospital or population control. The increased risk was robust to several sensitivity analyses. Factors that were significantly associated with increased hazards of stroke were: advanced age, male gender, diabetes mellitus, hypertension, coronary artery disease, chronic heart failure, chronic kidney disease, chronic obstruction pulmonary disease, and new-onset atrial fibrillation. Only diabetes mellites [aHR 1.80 (95% CI, 1.12–2.91)], hypertension [aHR 2.2 (95% CI, 2.03–2.52)], coronary artery disease [HR 1.64 (95% CI, 1.49–1.80)], and new-onset atrial fibrillation [aHR 1.80 (95% CI, 1.42–2.28)], were associated with > 50% increase in hazards. CONCLUSION: Our findings showed a significant association between sepsis and a subsequent risk of cerebrovascular events. The risk of cerebrovascular events can be predicated by patient and sepsis-related baseline variables. New therapeutic strategies are needed for the high-risk patients. Frontiers Media S.A. 2022-11-25 /pmc/articles/PMC9732021/ /pubmed/36507522 http://dx.doi.org/10.3389/fmed.2022.1065476 Text en Copyright © 2022 Arero, Vasheghani-Farahani, Tigabu, Arero, Ayene and Soltani. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Arero, Amanuel Godana
Vasheghani-Farahani, Ali
Tigabu, Bereket Molla
Arero, Godana
Ayene, Beniyam Yimam
Soltani, Danesh
Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title_full Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title_fullStr Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title_full_unstemmed Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title_short Long-term risk and predictors of cerebrovascular events following sepsis hospitalization: A systematic review and meta-analysis
title_sort long-term risk and predictors of cerebrovascular events following sepsis hospitalization: a systematic review and meta-analysis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732021/
https://www.ncbi.nlm.nih.gov/pubmed/36507522
http://dx.doi.org/10.3389/fmed.2022.1065476
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