Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy.
Liverpool Centre for Cardiovascular Science, at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom, Liverpool, UK.
Intern Emerg Med. 2023 Jan;18(1):127-135. doi: 10.1007/s11739-022-03135-1. Epub 2022 Nov 4.
Community-acquired pneumonia (CAP) is a common lower respiratory tract infection, often complicated by cardiovascular events, including cardiac arrhythmias. New-onset atrial fibrillation (newAF) has been associated with increased mortality in CAP patients, especially in those critically ill; however, limited data on the prevalence of newAF in patients with CAP are available. We aim to estimate the pooled prevalence of newAF and its impact on adverse outcomes in patients with CAP, through a systematic review and meta-analysis. MEDLINE and EMBASE were systematically searched from inception to 27 January 2022. All studies reporting the prevalence of newAF in CAP patients were included and all-cause mortality was extracted when available. The pooled prevalence of newAF, 95% Confidence Intervals (CI), and 95% Prediction Intervals (PI) were computed. The inconsistency index (I) was calculated to measure heterogeneity. Subgroup analyses were also performed. A protocol for this study was registered on PROSPERO (CRD42022307422). Among 7,655 records retrieved, 10 studies were included, with a total of 280,589 CAP patients. Pooled prevalence of newAF in CAP patients was 7.6% (95% CI 6.4-9.0%, 95% PI 4.3-13.1%, I = 95%). Subgroup analyses showed no significant differences according to geographical location or study design. Patients with newAF had a higher risk of mortality among the studies included in the systematic review. NewAF is a common complication, occurring in 7.6% of CAP patients, with prediction intervals suggesting an even higher burden. CAP patients who develop newAF during hospitalization may be at higher risk of mortality in both short- and long-term follow-up.
社区获得性肺炎（CAP）是一种常见的下呼吸道感染，常伴有心血管事件，包括心律失常。新发心房颤动（newAF）与 CAP 患者的死亡率增加有关，尤其是重症患者；然而，关于 CAP 患者中 newAF 的患病率的有限数据。我们旨在通过系统评价和荟萃分析，评估 CAP 患者中新发心房颤动的患病率及其对不良结局的影响。系统检索了 MEDLINE 和 EMBASE 从建库到 2022 年 1 月 27 日的数据。纳入了所有报告 CAP 患者中新发心房颤动患病率的研究，并在有数据可用时提取了全因死亡率。计算了新发心房颤动的汇总患病率、95%置信区间（CI）和 95%预测区间（PI）。计算了不一致指数（I）以衡量异质性。还进行了亚组分析。本研究方案已在 PROSPERO（CRD42022307422）上注册。在检索到的 7655 条记录中，纳入了 10 项研究，共纳入 280589 例 CAP 患者。CAP 患者新发心房颤动的汇总患病率为 7.6%（95%CI 6.4-9.0%，95%PI 4.3-13.1%，I=95%）。亚组分析显示，地理位置或研究设计不同，差异无统计学意义。纳入系统评价的研究中，新发心房颤动患者的死亡率更高。新发心房颤动是 CAP 患者的一种常见并发症，发生率为 7.6%，预测区间提示发病率更高。在住院期间发生新发心房颤动的 CAP 患者，在短期和长期随访中，其死亡风险可能更高。
