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早期高敏肌钙蛋白升高预测脓毒症短期死亡率:系统评价和荟萃分析方案。

Early high-sensitivity troponin elevation in predicting short-term mortality in sepsis: A protocol for a systematic review with meta-analysis.

机构信息

Faculty of medicine, School of medicine, Universidad de Chile, Santiago, Chile.

Faculty of Medicine, Dentistry School, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.

出版信息

PLoS One. 2024 Oct 25;19(10):e0301948. doi: 10.1371/journal.pone.0301948. eCollection 2024.

Abstract

BACKGROUND

Sepsis is a common admission diagnosis in the intensive care unit (ICU). The Sepsis-3 consensus associates sepsis diagnosis with acute organ dysfunction. In these patients troponin elevation is a well-established phenomenon, but its clinical significance is not settled, as no systematic review has addressed the prognostic significance of the increasingly prevalent high-sensitivity troponin assays in acute organ dysfunction setting. This study aims to clarify the association between early serum troponin levels in high-sensitivity assays with short-term mortality risk in septic patients with acute organ dysfunction.

METHODS

We will systematically search PubMed, Scopus and Embase for original articles; additionally, a manual search will be carried out through relevant literature. Generally, studies will be deemed eligible for inclusion if they evaluate the association between high-sensitivity troponin in the first 24 hours of admission and ICU, 30-days, or In-hospital mortality; in patients with septic shock or sepsis related to acute organ dysfunction. Two reviewers will independently select studies and extract the data. A meta-analysis for mortality outcome will be performed for comparative data regarding two effect measures: Odd ratios and Standardized Mean differences.

DISCUSSION

This study will provide further evidence about the role of high-sensitivity troponin assays in predicting mortality in septic patients; potentially helping to guide further research and yielding valuable information for patient assessment. Conclusion about the certainty of evidence will be presented in a ´Summary of findings´ table.

TRIAL REGISTRATION

PROSPERO registration: (CRD42024468883).

摘要

背景

脓毒症是重症监护病房(ICU)常见的入院诊断。Sepsis-3 共识将脓毒症诊断与急性器官功能障碍相关联。在这些患者中,肌钙蛋白升高是一种已确立的现象,但它的临床意义尚未确定,因为没有系统评价探讨在急性器官功能障碍背景下日益普及的高敏肌钙蛋白检测的预后意义。本研究旨在阐明在急性器官功能障碍的脓毒症患者中,早期高敏肌钙蛋白水平与短期死亡率风险之间的关系。

方法

我们将系统地在 PubMed、Scopus 和 Embase 上搜索原始文章;此外,还将通过相关文献进行手动搜索。如果研究评估了入院后 24 小时内高敏肌钙蛋白与 ICU、30 天或住院死亡率之间的关系,并且研究对象为脓毒性休克或与急性器官功能障碍相关的脓毒症患者,则通常认为这些研究符合纳入标准。两位审查员将独立选择研究并提取数据。对于死亡率结局的比较数据,将进行荟萃分析,比较两种效应测量值:比值比和标准化均数差。

讨论

本研究将提供进一步的证据,说明高敏肌钙蛋白检测在预测脓毒症患者死亡率方面的作用;可能有助于指导进一步的研究,并为患者评估提供有价值的信息。将在“研究结果总结”表中提出关于证据确定性的结论。

试验注册

PROSPERO 注册:(CRD42024468883)。

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