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Table 3 Summary of main results of primary and secondary outcomes

From: Levosimendan for patients with severely reduced left ventricular systolic function and/or low cardiac output syndrome undergoing cardiac surgery: a systematic review and meta-analysis

 

Heterogeneity

Outcome analyzed

Studies

Patients

OR or SMD (95% CI)

p Value

I 2 Statistic

p Value

Mortality overall

6

1728

OR 0.64 (0.37, 1.11)

0.11

42%

0.12

Mortality in low LVEF

5

1224

OR 0.51 (0.32, 0.82)

0.005

0%

0.66

Need for RRT overall

6

1728

OR 0.63 (0.42, 0.94)

0.02

0%

0.91

Need for RRT in low LVEF

5

1224

OR 0.55 (0.31, 0.97)

0.04

0%

0.90

AF and SVT overall

5

1695

OR 0.62 (0.32, 1.18)

0.15

79%

0.0007

AF and SVT in low LVEF

4

1141

OR 0.52 (0.19, 1.40)

0.20

84%

0.0003

Myocardial damage overall

4

1645

OR 0.89 (0.52, 1.53)

0.68

29%

0.24

Myocardial damage in low LVEF

3

1141

OR 0.60 (0.15, 2.41)

0.47

53%

0.12

Mechanical support overall

6

1728

OR 0.38 (0.13, 1.10)

0.07

82%

<0.0001

Mechanical support in low LVEF

5

1224

OR 0.29 (0.09, 1.00)

0.05

85%

<0.0001

Hypotension overall

5

1695

OR 1.41 (0.92, 2.18)

0.12

0%

0.54

Hypotension in low LVEF

4

1191

OR 1.31 (0.82, 2.08)

0.26

0%

0.52

LCOS in low LVEF

4

1191

OR 0.55 (0.38, 0.79)

0.001

9%

0.35

AKI (risk, injury, failure of RIFLE criteria)

3

817

OR 0.64 (0.44, 0.94)

0.02

9%

0.33

Duration of MV overall

3

567

SMD −0.11 (−0.28, 0.05)

0.18

0%

0.61

ICU LOS overall

4

1419

SMD −0.41 (−0.83, 0.02)

0.06

89%

<0.0001

ICU LOS in low LVEF

3

962

SMD −0.78 (−1.90, 0.34)

0.17

92%

<0.0001

Hospital LOS overall

3

567

SMD −0.73 (−1.89, 0.43)

0.22

93%

<0.0001

  1. Abbreviations: AF Atrial fibrillation, AKI Acute kidney injury, ICU Intensive care unit, LCOS Low cardiac output syndrome, LOS Length of stay, LVEF Left ventricular ejection fraction, MV Mechanical ventilation, PICOS Population, intervention, comparison, outcomes, and study design, RIFLE Risk, injury, failure; loss, end-stage renal disease, RRT Renal replacement therapy, SMD Standard mean difference, SVT Supraventricular tachycardia
  2. Results are presented as OR or SMD, as appropriate, with 95% CI. Results presented in bold are statistically significant or with a trend toward statistically significant result