The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis
Background: Prolonged mechanical ventilation (PMV) is a common complication after cardiac surgery and is considered a risk factor for poor outcomes. However, the incidence and in-hospital mortality of PMV among cardiac surgery patients reported in studies vary widely, and risk fac...
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IMR Press
2024-11-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511409 |
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| author | Qiaoying Wang Yuanyuan Tao Xu Zhang Shurong Xu Yanchun Peng Lingyu Lin Liangwan Chen Yanjuan Lin |
| author_facet | Qiaoying Wang Yuanyuan Tao Xu Zhang Shurong Xu Yanchun Peng Lingyu Lin Liangwan Chen Yanjuan Lin |
| author_sort | Qiaoying Wang |
| collection | DOAJ |
| description | Background: Prolonged mechanical ventilation (PMV) is a common complication after cardiac surgery and is considered a risk factor for poor outcomes. However, the incidence and in-hospital mortality of PMV among cardiac surgery patients reported in studies vary widely, and risk factors are controversial. Methods: We searched four databases (Web of Science, Cochrane Library, PubMed, and EMBASE) for English-language articles from inception to October 2023. The odds ratio (OR), 95% confidence interval (CI), PMV incidence, and in-hospital mortality were extracted. Statistical data analysis was performed using Stata software. We calculated the fixed or random effects model according to the heterogeneity. The quality of each study was appraised by two independent reviewers using the Newcastle–Ottawa scale. Results: Thirty-two studies were included. The incidence of PMV was 20%. Twenty-one risk factors were pooled, fifteen risk factors were found to be statistically significant (advanced age, being female, ejection fraction <50, body mass index (BMI), BMI >28 kg/m2, New York Heart Association Class ≥Ⅲ, chronic obstructive pulmonary disease, chronic renal failure, heart failure, arrhythmia, previous cardiac surgery, higher white blood cell count, creatinine, longer cardiopulmonary bypass (CPB) time, and CPB >120 min). In addition, PMV was associated with increased in-hospital mortality (OR, 14.13, 95% CI, 12.16–16.41, I2 = 90.3%, p < 0.01). Conclusions: The PMV incidence was 20%, and it was associated with increased in-hospital mortality. Fifteen risk factors were identified. More studies are needed to prevent PMV more effectively according to these risk factors. The PROSPERO Registration: This systematic review and meta-analysis was recorded at PROSPERO (CRD42021273953, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273953). |
| format | Article |
| id | doaj-art-4418c76d3d53459d88657b294dba3047 |
| institution | OA Journals |
| issn | 1530-6550 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-4418c76d3d53459d88657b294dba30472025-08-20T02:07:34ZengIMR PressReviews in Cardiovascular Medicine1530-65502024-11-01251140910.31083/j.rcm2511409S1530-6550(24)01525-4The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-AnalysisQiaoying Wang0Yuanyuan Tao1Xu Zhang2Shurong Xu3Yanchun Peng4Lingyu Lin5Liangwan Chen6Yanjuan Lin7The School of Nursing, Fujian Medical University, 350005 Fuzhou, Fujian, ChinaDepartment of Nursing, Jingmen Peoples Hospital, 448001 Jingmen, Hubei, ChinaDepartment of Nursing, Women and Children’s Hospital, School of Medicine, Xiamen University, 361005 Xiamen, Fujian, ChinaThe School of Nursing, Fujian Medical University, 350005 Fuzhou, Fujian, ChinaDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, ChinaDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, ChinaDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, ChinaDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, ChinaBackground: Prolonged mechanical ventilation (PMV) is a common complication after cardiac surgery and is considered a risk factor for poor outcomes. However, the incidence and in-hospital mortality of PMV among cardiac surgery patients reported in studies vary widely, and risk factors are controversial. Methods: We searched four databases (Web of Science, Cochrane Library, PubMed, and EMBASE) for English-language articles from inception to October 2023. The odds ratio (OR), 95% confidence interval (CI), PMV incidence, and in-hospital mortality were extracted. Statistical data analysis was performed using Stata software. We calculated the fixed or random effects model according to the heterogeneity. The quality of each study was appraised by two independent reviewers using the Newcastle–Ottawa scale. Results: Thirty-two studies were included. The incidence of PMV was 20%. Twenty-one risk factors were pooled, fifteen risk factors were found to be statistically significant (advanced age, being female, ejection fraction <50, body mass index (BMI), BMI >28 kg/m2, New York Heart Association Class ≥Ⅲ, chronic obstructive pulmonary disease, chronic renal failure, heart failure, arrhythmia, previous cardiac surgery, higher white blood cell count, creatinine, longer cardiopulmonary bypass (CPB) time, and CPB >120 min). In addition, PMV was associated with increased in-hospital mortality (OR, 14.13, 95% CI, 12.16–16.41, I2 = 90.3%, p < 0.01). Conclusions: The PMV incidence was 20%, and it was associated with increased in-hospital mortality. Fifteen risk factors were identified. More studies are needed to prevent PMV more effectively according to these risk factors. The PROSPERO Registration: This systematic review and meta-analysis was recorded at PROSPERO (CRD42021273953, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273953).https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511409cardiac surgical patientsin-hospital mortalitymeta-analysisprolonged mechanical ventilationrisk factors |
| spellingShingle | Qiaoying Wang Yuanyuan Tao Xu Zhang Shurong Xu Yanchun Peng Lingyu Lin Liangwan Chen Yanjuan Lin The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis Reviews in Cardiovascular Medicine cardiac surgical patients in-hospital mortality meta-analysis prolonged mechanical ventilation risk factors |
| title | The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis |
| title_full | The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis |
| title_fullStr | The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis |
| title_short | The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis |
| title_sort | incidence risk factors and hospital mortality of prolonged mechanical ventilation among cardiac surgery patients a systematic review and meta analysis |
| topic | cardiac surgical patients in-hospital mortality meta-analysis prolonged mechanical ventilation risk factors |
| url | https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511409 |
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