研究方案：关于凝血功能障碍和免疫激活对脓毒症患者新发心房颤动影响的系统评价和荟萃分析。
Study protocol: A systematic review and meta-analysis regarding the influence of coagulopathy and immune activation on new onset atrial fibrillation in patients with sepsis.
机构信息
School of Medicine, Faculty of Health and Life Sciences, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
出版信息
PLoS One. 2023 Sep 8;18(9):e0290963. doi: 10.1371/journal.pone.0290963. eCollection 2023.
BACKGROUND
New onset atrial fibrillation (NOAF) is the most common arrhythmia affecting critically ill patients with sepsis. NOAF is associated with increased intensive care unit mortality, increased hospital mortality, development of heart failure and increased risk of permanent atrial fibrillation and thromboembolic events such as stroke. The pathophysiology of NOAF has been outlined, however, a knowledge gap exists regarding the association between abnormalities in coagulation and immune biomarkers, and the risk of developing NOAF in patients with sepsis.
METHODS AND ANALYSIS
This protocol describes a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline (PRISMA-P) and the Meta-Analyses and Systematic Reviews of Observational Studies guideline (MOOSE). We will conduct the literature search in Medline, Scopus and Cochrane Library. We will include studies that report data in adult patients (>18 years) with sepsis that develop NOAF. We will extract data from studies that report at least one coagulation or immune biomarker. Risk of bias will be assessed by using the Newcastle Ottawa Scale (NOS) and Risk of Bias 2 tool (RoB2) for non-randomized and randomized trials respectively. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be utilized in assessing the quality of evidence.
DISCUSSION
This systematic review and meta-analysis will explore the scientific literature regarding the association between coagulation and immune activation in critically ill patients with sepsis, who develop NOAF. The findings will add to the existing knowledge base of NOAF in sepsis, highlight areas of uncertainty and identify future areas of interest to guide and improve management strategies for NOAF.
TRIAL REGISTRATION
Registration details. CRD42022385225 (PROSPERO).
背景
新发心房颤动（NOAF）是影响脓毒症重症患者最常见的心律失常。NOAF 与重症监护病房死亡率增加、住院死亡率增加、心力衰竭发展以及永久性心房颤动和血栓栓塞事件（如中风）风险增加有关。NOAF 的病理生理学已经概述，但关于脓毒症患者凝血和免疫生物标志物异常与发生 NOAF 的风险之间的关联，仍存在知识空白。
方法和分析
本方案按照系统评价和荟萃分析的首选报告项目（PRISMA-P）和观察性研究的荟萃分析和系统评价指南（MOOSE）描述了一项系统评价和荟萃分析。我们将在 Medline、Scopus 和 Cochrane Library 中进行文献检索。我们将纳入报告脓毒症成人患者（>18 岁）发生 NOAF 的研究。我们将从报告至少一种凝血或免疫生物标志物数据的研究中提取数据。使用纽卡斯尔-渥太华量表（NOS）和风险偏倚 2 工具（RoB2）分别评估非随机和随机试验的风险偏倚。将使用推荐评估、制定与评估（GRADE）方法评估证据质量。
讨论
本系统评价和荟萃分析将探讨有关脓毒症重症患者中凝血和免疫激活与发生 NOAF 的科学文献。研究结果将增加脓毒症中 NOAF 的现有知识库，突出不确定性领域，并确定未来感兴趣的领域，以指导和改善 NOAF 的管理策略。
试验注册
注册详情。CRD42022385225（PROSPERO）。
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