Prevalence and risk factors of sepsis-induced cardiomyopathy: A retrospective cohort study.
The aim of the study is to evaluate the epidemiology and clinical features of sepsis-induced cardiomyopathy (SICM).A retrospective cohort study was conducted.A total of 210 adult patients with sepsis or septic shock admitted to a Japanese tertiary care hospital from January 1, 2013, to December 31, 2015, who underwent transthoracic echocardiography (TTE) on admission.The definition of SICM was ejection fraction (EF) < 50% and a ≥10% decrease compared to the baseline EF which recovered within 2 weeks, in sepsis or septic shock patients.Our primary outcome was the incidence rate of SICM. Our secondary outcomes were the in-hospital mortality rate and length of intensive care unit (ICU) stay according to the presence or absence of SICM. In total, 29 patients (13.8%) were diagnosed with SICM. The prevalence rate of SICM was significantly higher in male than in female (P = 0.02). Multivariate logistic regression analyses revealed that the incidence of SICM was associated with younger age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95-0.99), higher lactate level on admission (OR, 1.18; 95% CI, 1.05-1.32) and history of heart failure (HF) (OR, 3.77; 95% CI, 1.37-10.40). There were no significant differences in the in-hospital and 30-day mortality between patients with and without SICM (24.1% vs 12.7%, P = 0.15; 20.7% vs 12.1%, P = 0.23). Lengths of hospital and ICU stay were significantly longer in patients with SICM than in those without SICM (median, 43 vs 26 days, P = 0.04; 9 vs 5 days, P < 0.01).SICM developed in 13.8% of patients with sepsis and septic shock. A younger age, higher lactate levels on admission and history of HF were risk factors.
aDepartment of Emergency and Critical Care Medicine, Urasoe General Hospital bDepartment of General Medicine, Kurashiki Central Hospital cDepartment of Anesthesia, Urasoe General Hospital, Okinawa, Japan.
Ryota
R
Sato
Akira
A
Kuriyama
Tadaaki
T
Takada
Michitaka
M
Nasu
Sarah Kyuragi
SK
Luthe
D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
J Exp Med. 1989 Mar 1;169(3):823-32
2647895
Anesthesiology. 1991 Jan;74(1):172-83
1986643
J Exp Med. 1996 Mar 1;183(3):949-58
8642298
Crit Care. 2013 May 27;17(3):R96
23706109
Anesthesiology. 2001 Mar;94(3):400-6
11374597
Lancet. 2003 Jan 11;361(9352):130-5
12531580
Acta Anaesthesiol Scand. 2013 Apr;57(4):431-42
23298252
JAMA. 2013 Oct 23;310(16):1683-91
24108526
Crit Care Med. 2009 Feb;37(2):441-7
19114917
N Engl J Med. 1994 Jun 16;330(24):1717-22
7993413
J Am Coll Cardiol. 1999 Mar 15;33(4):1062-70
10091837
Intensive Care Med. 2013 Aug;39(8):1435-43
23740284
N Engl J Med. 1995 Oct 19;333(16):1025-32
7675044
Ann Intern Med. 1984 Apr;100(4):483-90
6703540
Crit Care Med. 2008 Jun;36(6):1701-6
18496368
N Engl J Med. 2001 Nov 8;345(19):1368-77
11794169
J Intensive Care. 2015 Nov 11;3:48
26566443
Crit Care Med. 1990 Oct;18(10 ):1055-60
2209030
N Engl J Med. 2003 Apr 17;348(16):1546-54
12700374
Crit Care. 2013 Jul 04;17(4):164
23826739
JAMA. 2014 Apr 2;311(13):1308-16
24638143
JAMA. 2016 Feb 23;315(8):801-10
26903338
Intensive Care Med. 2008 Feb;34(2):250-6
18004543