A Meta-Analytic Perspective on Echocardiographic Signs of Long-Term Cardiac Dysfunction After Burns, Sepsis, and Trauma.
Tobias Niederegger, Emre Karakas, Thomas Schaschinger et al.
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In 30 seconds
This meta-analysis assessed echocardiographic evidence of cardiac dysfunction after severe burns, sepsis, and major trauma. It included 47 studies and 3,117 patients: 1,876 with burns, 959 with sepsis, and 282 with trauma. Left ventricular ejection fraction was the most frequently reported measure, appearing in 35 studies (73%). The authors found signals of persistent myocardial alteration, described as most pronounced among burn survivors, but substantial differences in study design, patient selection, assessment, and follow-up prevented reliable comparison of cardiac trajectories across conditions.
Key findings
- The meta-analysis included 47 studies (n = 3,117): trauma: 282, sepsis: 959, burns: 1,876.
- LVEF was reported in n = 35 (73%) studies, but substantial heterogeneity limited comparisons.
- Median follow-up was 9 days for sepsis, 10 for trauma, and 447 for burns.
- The authors identified signals of long-term myocardial alteration, most pronounced in burn survivors.
Why it matters
Cardiac changes after critical illness may persist beyond the acute phase, but the available evidence does not yet establish how these changes evolve or differ among burns, sepsis, and trauma. Recognising the limited and uneven evidence base is important when interpreting echocardiographic findings and considering the need for better longitudinal assessment.
What to keep in mind
Marked heterogeneity in study design, patient selection, illness severity, echocardiographic assessment, and follow-up timing limited direct comparisons. Longitudinal data were scarce, particularly for trauma and sepsis.