In-Hospital Neurologic Complications, Neuromonitoring, and Long-Term Neurologic Outcomes in Patients With Sepsis: A Systematic Review and Meta-Analysis
Authors' conclusion
In-hospital neurologic complications are common in patients with sepsis.
Study context
- Population
- Adults with sepsis
- Participants
- 146,855 adults · 74 studies
- Outcome
- Prevalence of neurologic complications
Methodological detailsrandom-effects meta-analysis, meta-regression
- Random-effects meta-analysis
- Meta-regression
Pooled result
As reported in the abstract
In-hospital neurologic complications (38 studies, n = 142,193)
- Septic encephalopathy
- 36% (95% CI 27-46%; I² = 99%)
- Ischemic stroke
- 5% (95% CI 2.1-11.5; I² = 99%)
- Intracranial hemorrhage
- 2% (95% CI 1.0-4.4%; I² = 96%)
- Seizures
- 1% (95% CI 0.2-7%; I² = 96%)
- Posterior reversible encephalopathy syndrome
- 9%
- Hypoxic-ischemic brain injury
- 7%
Further pooled results
Risk factors for septic encephalopathy (meta-regression)
- Pulmonary infection, gram-positive sepsis, higher SOFA and APACHE II score at admission, longer ICU LOS associated with higher risk
Acute brain injury on postmortem neuropathology (3 studies, n = 159)
- Acute brain injury
- 47%
Neuromonitoring tools (26 studies, n = 1,358)
- EEG most used for seizure detection; transcranial Doppler and near infrared spectroscopy for cerebral hemodynamics to detect early ischemia
Cognitive impairment (≥ one domain) (6 studies, n = 415) · up to 12 months postdischarge
- Cognitive impairment
- 30%
Original publication
In-Hospital Neurologic Complications, Neuromonitoring, and Long-Term Neurologic Outcomes in Patients With Sepsis: A Systematic Review and Meta-Analysis. Crit Care Med. Published 3 November 2023. doi:10.
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