Acute Crit Care.  2021 Aug;36(3):215-222. 10.4266/acc.2021.00234.

Sepsis-induced cardiomyopathy is associated with higher mortality rates in patients with sepsis

• Hanumanthu BKJ
• Nair AS
• Katamreddy A
• Gilbert JS
• You JY
• Offor OL
• Kushwaha A
• Krishnan A
• Napolitano M
• Palaidimos L
• Morante J
• Tekwani SS
• Mehta S
• Gupta A
• Goraya H
• Sun M
• Faillace RT
• Gulani P

• KMID: 2519448
• DOI: http://doi.org/10.4266/acc.2021.00234

Abstract

Background
Patients with sepsis are at risk for developing sepsis-induced cardiomyopathy (SIC). Previous studies offer inconsistent results regarding the association of SIC and mortality. This study sought to assess whether SIC is linked to mortality in patients with sepsis and to evaluate predictors of the development of SIC.
Methods
In this retrospective study, patients admitted to the medical intensive care unit with a diagnosis of sepsis in the absence of acute coronary syndrome were included. SIC was identified using transthoracic echo and was defined by a new onset decline in left ventricular ejection fraction (LVEF) ≤50%, or ≥10% decline in LVEF compared to baseline in patients with a history of heart failure with reduced ejection fraction. Multivariable logistic regression analysis was performed using the R software program.
Results
Of the 359 patients in the final analysis, 19 (5.3%) had SIC. Eight (42.1%) of the 19 patients in the SIC group and 60 (17.6%) of the 340 patients in the non-SIC group died during hospitalization. SIC was associated with an increased risk for all-cause in-hospital mortality (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.15–18.69; P=0.03). Independent predictors for the development of SIC were albumin level (OR, 0.47; 95% CI, 0.23–0.93; P=0.03) and culture positivity (OR, 8.47; 95% CI, 2.24–55.61; P=0.006). Concomitant right ventricular hypokinesis was noted in 13 (68.4%) of the 19 SIC patients.
Conclusions
SIC was associated with an increased risk for all-cause in-hospital mortality. Low albumin level and culture positivity were independent predictors of SIC.

Keyword

cardiomyopathy; mortality; sepsis; septic shock

Figure

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  Figure 1. Patient flowchart. ICU: intensive care unit; TTE: transthoracic echocardiogram; ACS: acute coronary syndrome; LVEF: left ventricular ejection fraction; SIC: sepsis-induced cardiomyopathy.

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