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. 2024 May 21:11:1379019.
doi: 10.3389/fmed.2024.1379019. eCollection 2024.

Factors contributing to sepsis-associated encephalopathy: a comprehensive systematic review and meta-analysis

Zhiyang Zhang  1   2 , Li Guo  3 , Lijing Jia  2 , Hong Duo  4 , Limin Shen  2 , Heling Zhao  1   2
Affiliations

Factors contributing to sepsis-associated encephalopathy: a comprehensive systematic review and meta-analysis

Zhiyang Zhang et al. Front Med (Lausanne). .

Abstract

Background: This study aims to systematically assess the risk factors, the overall strength of association, and evidence quality related to sepsis-associated encephalopathy.

Methods: A systematic search was conducted in the Cochrane Library, PubMed, Web of Science, and Embase for cohort or case-control studies published up to August 2023 on risk factors associated with sepsis-related encephalopathy. The selected studies were screened, data were extracted, and the quality was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed using RevMan 5.3 software. The certainty of the evidence was assessed using the GRADE criteria.

Results: A total of 13 studies involving 1,906 participants were included in the analysis. Among these studies, 12 were of high quality, and one was of moderate quality. Our meta-analysis identified six risk factors significantly associated with Serious Adverse Events (SAE). These included APACHE II, SOFA, age, tau protein, and IL-6, which were found to be risk factors with significant effects (standard mean difference SMD: 1.24-2.30), and albumin, which was a risk factor with moderate effects (SMD: -0.55). However, the certainty of evidence for the risk factors identified in this meta-analysis ranged from low to medium.

Conclusion: This systematic review and meta-analysis identified several risk factors with moderate to significant effects. APACHE II, SOFA, age, tau protein, IL-6, and albumin were associated with sepsis-related encephalopathy and were supported by medium- to high-quality evidence. These findings provide healthcare professionals with an evidence-based foundation for managing and treating hospitalized adult patients with sepsis-related encephalopathy.

Keywords: delirium; encephalopathy; meta-analysis; risk factors; sepsis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the literature and selection in the meta-analysis.
Figure 2
Figure 2
Forest plot of the studies in APACHEII.
Figure 3
Figure 3
Forest plot of the studies in SOFA.
Figure 4
Figure 4
Forest plot of the studies in age.
See this image and copyright information in PMC

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References

    1. Slooter AJC, Otte WM, Devlin JW, Arora RC, Bleck TP, Claassen J, et al. . Updated nomenclature of delirium and acute encephalopathy: statement of ten societies. Intensive Care Med. (2020) 46:1020–2. doi: 10.1007/s00134-019-05907-4, PMID: - DOI - PMC - PubMed
    1. Wilson JX, Young GB. Progress in clinical neurosciences: sepsis-associated encephalopathy: evolving concepts. Can J Neurol Sci. (2003) 30:98–105. doi: 10.1017/S031716710005335X, PMID: - DOI - PubMed
    1. Iacobone E, Bailly-Salin J, Polito A, Friedman D, Stevens RD, Sharshar T. Sepsis-associated encephalopathy and its differential diagnosis. Crit Care Med. (2009) 37:S331–6. doi: 10.1097/CCM.0b013e3181b6ed58 - DOI - PubMed
    1. Heming N, Mazeraud A, Verdonk F, Bozza FA, Chrétien F, Sharshar T. Neuroanatomy of sepsis-associated encephalopathy. Crit Care. (2017) 21:65. doi: 10.1186/s13054-017-1643-z, PMID: - DOI - PMC - PubMed
    1. Sharshar T, Annane D, de la Grandmaison GL, Brouland JP, Hopkinson NS, Françoise G. The neuropathology of septic shock. Brain Pathol. (2004) 14:21–33. doi: 10.1111/j.1750-3639.2004.tb00494.x - DOI - PMC - PubMed

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