Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3511-3521
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3511
Impact of heart failure on outcomes in patients with sepsis: A systematic review and meta-analysis
Ming-Yu Zhu, Xiao-Kai Tang, Yi Gao, Jing-Jing Xu, Yuan-Qi Gong
Ming-Yu Zhu, Yi Gao, Jing-Jing Xu, Yuan-Qi Gong, Department of the Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Xiao-Kai Tang, Department of the Orthopaedic, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Zhu MY conceived the study and wrote the paper; Tang XK and Xu JJ performed literature search and data collection; Gao Y designed the study and analyzed the data; Gong YQ revised the study and paper; all authors read and approved the final manuscript.
Supported by The National Natural Science Foundation of China, No. 8186080205 and No. 8226080303.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Qi Gong, MD, PhD, Professor, Department of the Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, No. 1 Demin Road, Donghu District, Nanchang 330006, Jiangxi Province, China. 760225787@qq.com
Received: February 7, 2023
Peer-review started: February 7, 2023
First decision: February 28, 2023
Revised: March 6, 2023
Accepted: April 6, 2023
Article in press: April 6, 2023
Published online: May 26, 2023
Processing time: 107 Days and 6.8 Hours
Abstract
BACKGROUND

Heart failure (HF) often affects the progress of sepsis patients, although its impact on outcomes is inconsistent and inconclusive.

AIM

To conduct a systematic review and meta-analysis of the impact of HF on mortality in patients with sepsis.

METHODS

PubMed, Embase, Web of Science, and the Cochrane Library databases were searched to compare the outcomes of sepsis patients with HF. A random effect model was used to summarize the mortality data, and the odds ratio (OR) and 95% confidence interval (CI) were calculated as effect indicators.

RESULTS

Among 18001 records retrieved in the literature search, 35712 patients from 10 separate studies were included. The results showed that sepsis patients with HF were associated with increased total mortality (OR = 1.80, 95%CI: 1.34-2.43; I2 = 92.1%), with high heterogeneity between studies. Significant subgroup differences according to age, geographical location, and HF patient sample were observed. HF did not increase the 1-year mortality of patients (OR = 1.11, 95%CI: 0.75-1.62; I2 = 93.2%), and the mortality of patients with isolated right ventricular dysfunction (OR=2.32, 95%CI: 1.29-4.14; I2 = 91.5%) increased significantly.

CONCLUSION

In patients with sepsis, HF is often associated with adverse outcomes and mortality. Our results call for more high-quality research and strategies to improve outcomes for sepsis patients with HF.

Keywords: Heart failure; Sepsis; Septic shock; Prognosis; Meta-analysis

Core Tip: Heart failure (HF) treatment and management measures in sepsis patients have been optimized and improved. However, it is still controversial whether HF will worsen the clinical outcomes of sepsis patients. We conducted a meta-analysis to determine if HF tends to increase the risk of death in sepsis patients. Limited by significant publication bias, this issue requires more high-quality research and a focus on strategies to improve outcomes in sepsis patients with HF.