Scholarlink

Introduction <p>In critically ill patients with trigger-induced atrial fibrillation, there are no definitive recommendations on the use of anticoagulation. This study aimed to evaluate the association between anticoagulation therapy and outcomes (i.e. thromboembolism, bleeding and mortality) and examine prescription patterns in high-risk individuals based on CHA<sub>2</sub>DS<sub>2</sub>-VASc scores.</p> Methods <p>A&#xa0;systematic search was conducted to identify studies reporting on anticoagulation prescription, thromboembolism, bleeding, and mortality. Anticoagulation rates and CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were correlated, and a&#xa0;meta-analysis was conducted to compare short- and long-term outcomes.</p> Results <p>Anticoagulation prescription rates ranged from 3&#xa0;to 86%; in over 50% of patients, CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were ≥ 2 (<i>n</i> = 28&#xa0;studies). A&#xa0;meta-analysis of eight observational studies, in which 95% of patients had sepsis/infection as the precipitant, demonstrated no association between anticoagulation and reduced short-term thromboembolism (OR 0.89, 95% CI 0.61–1.28) or increased bleeding (OR 1.05, 95% CI 0.90–1.22). Short-term mortality was lower in the anticoagulation group (OR 0.54, 95% CI 0.39–0.75), but a&#xa0;higher long-term thromboembolic risk was observed (OR 1.45, 95% CI 1.04–2.03).</p> Conclusion <p>The prescription of anticoagulation in critically ill patients with TIAF is highly variable. There is no clear evidence of benefit or harm, and neither routine use nor systematic omission is supported.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Anticoagulation and thromboembolic risk in critically ill patients with trigger-induced atrial fibrillation—A systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月28日

查看全文
  • Jasper Koolwijk,
  • Mileen van de Kar,
  • Brittney A van der Woude,
  • Marcel van ’t Veer,
  • Harm Jan de Grooth,
  • Harry J. G. M. Crijns,
  • Lukas R. C. Dekker,
  • R. Arthur Bouwman,
  • Olaf L. Cremer,
  • Ashley J. R. de Bie,
  • Luuk C. Otterspoor

摘要

Introduction

In critically ill patients with trigger-induced atrial fibrillation, there are no definitive recommendations on the use of anticoagulation. This study aimed to evaluate the association between anticoagulation therapy and outcomes (i.e. thromboembolism, bleeding and mortality) and examine prescription patterns in high-risk individuals based on CHA2DS2-VASc scores.

Methods

A systematic search was conducted to identify studies reporting on anticoagulation prescription, thromboembolism, bleeding, and mortality. Anticoagulation rates and CHA2DS2-VASc scores were correlated, and a meta-analysis was conducted to compare short- and long-term outcomes.

Results

Anticoagulation prescription rates ranged from 3 to 86%; in over 50% of patients, CHA2DS2-VASc scores were ≥ 2 (n = 28 studies). A meta-analysis of eight observational studies, in which 95% of patients had sepsis/infection as the precipitant, demonstrated no association between anticoagulation and reduced short-term thromboembolism (OR 0.89, 95% CI 0.61–1.28) or increased bleeding (OR 1.05, 95% CI 0.90–1.22). Short-term mortality was lower in the anticoagulation group (OR 0.54, 95% CI 0.39–0.75), but a higher long-term thromboembolic risk was observed (OR 1.45, 95% CI 1.04–2.03).

Conclusion

The prescription of anticoagulation in critically ill patients with TIAF is highly variable. There is no clear evidence of benefit or harm, and neither routine use nor systematic omission is supported.