Intens Care Med:成年危重病人新发房颤分析

2019-07-16 xing.T MedSci原创

由此可见,危重病患者NOAF的定义和发生率差异很大,并确定了许多危险因素。NOAF似乎与不良结局相关,但数据非常有限,目前的治疗策略不是以证据为基础的。

新发房颤(NOAF)很常见,并且与发病率和死亡率增加有关。然而,其在危重病人中的临床重要性和治疗尚未得到很好的描述。近日,危重病医学领域权威杂志Intensive Care Medicine上发表了一篇研究文章,该研究的目的是评估危重疾病期间NOAF的流行病学资料和治疗策略。

该系统评价是根据PRISMA标准进行,研究检索了PubMed、EMBASE和Cochrane图书馆,以评估成人重症患者NOAF的发病率、结局和治疗策略。使用建议评估、发展和评估(GRADE)方法评估证据质量。

该分析共纳入99项研究,其中79项为观察性研究,20项为干预性研究。NOAF的发病率从1.7%到43.9%不等,人群间差异很大(证据质量很低)。常见的NOAF危险因素包括年龄较大、心血管合并症和败血症。NOAF的发生与不良结局相关,包括卒中、住院时间延长和死亡率增加(证据质量非常低)。研究人员发现有关最佳治疗策略的数据有限,没有证据证明任何干预的益处或害处(证据质量非常低/低)。 

由此可见,危重病患者NOAF的定义和发生率差异很大,并确定了许多危险因素。NOAF似乎与不良结局相关,但数据非常有限,目前的治疗策略不是以证据为基础的。 

原始出处:

Mik Wetterslev,et al.New-onset atrial fibrillation in adult critically ill patients: a scoping review.Intensive Care Medicine.2019.https://www.esicm.org/icm-search/?id=doi:10.1007/s00134-019-05633-x#article

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