Key result
Cardiac dysfunction in adult patients with subarachnoid haemorrhage was associated with higher in-hospital mortality (OR 2.69; 95% CI 1.64 to 4.41; P<0.001).
Why the study?
SAH is associated with a massive release of catecholamines that may cause cardiac dysfunction and haemodynamic instability, but its prevalence and impact on clinical outcomes require systematic assessment.
Does the presence of cardiac dysfunction increase in-hospital mortality in adult patients with subarachnoid haemorrhage?
Systematic Review (n=3,511)
Does the presence of cardiac dysfunction increase in-hospital mortality in adult patients with subarachnoid haemorrhage?
Odds Ratio: 2.69 (95% CI 1.64–4.41)
p-value: p=< 0.001
In patients with subarachnoid hemorrhage, the development of cardiac dysfunction is associated with a nearly three-fold increase in the odds of in-hospital mortality.
Cardiac dysfunction signals higher mortality risk in subarachnoid hemorrhage; leaves open whether targeted intervention alters outcomes.
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.
No takes yet. Share an insight, caveat, or question.
Messina et al. (2023) conducted a systematic review in Subarachnoid haemorrhage (SAH) (n=3,511). Cardiac dysfunction vs. Absence of cardiac dysfunction was evaluated on In-hospital mortality (OR 2.69, 95% CI 1.64 to 4.41, p=< 0.001). Cardiac dysfunction in adult patients with subarachnoid haemorrhage was associated with higher in-hospital mortality (OR 2.69; 95% CI 1.64 to 4.41; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: