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

• Type of Material: Article
• Authors: Balaram Krishna J Hanumanthu, Beth Israel Medical Center; Anika Sasidharan Nair, Albert Einstein College of Medicine of Yeshiva University; Adarsh Katamreddy, Albert Einstein College of Medicine of Yeshiva University; Jason S Gilbert, Albert Einstein College of Medicine of Yeshiva University; Jee Young You, Albert Einstein College of Medicine of Yeshiva University; Obiageli Lynda Offor, Albert Einstein College of Medicine of Yeshiva University; Ankit Kushwaha, Albert Einstein College of Medicine of Yeshiva University; Ankita Krishnan, Albert Einstein College of Medicine of Yeshiva University; Marzio Napolitano, Albert Einstein College of Medicine of Yeshiva University; Leonidas Palaidimos, Albert Einstein College of Medicine of Yeshiva University; Joaquin Morante, Albert Einstein College of Medicine of Yeshiva University; Seema Tekwani, Emory University; Suchita Mehta, The Mount Sinai Hospital; Aanchal Gupta, Lahey Health; Harmeen Goraya, University of Arkansas at Little Rock; Mengyang Sun, Albert Einstein College of Medicine of Yeshiva University; Robert T Faillace, Albert Einstein College of Medicine of Yeshiva University; Perminder Gulani, Albert Einstein College of Medicine of Yeshiva University
• Language: English
• Date: 2021-08-01
• Publisher: The Korean Society of Critical Care Medicine
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Korean Society of Critical Care Medicine
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.4266/ACC.2021.00234
• Title of Journal or Parent Work: Acute and Critical Care
• Volume: 36
• Issue: 3
• Start Page: 215
• End Page: 222
• Keywords: mortality; sepsis; cardiomyopathy; septic shock
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Obstetrics and Gynecology

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.