Tricuspid annular plane systolic excursion is a predictor of mortality for septic shock.
cardiac function
echocardiography
septic shock
tissue Doppler imaging (TDI)
tricuspid annular plane systolic excursion (TAPSE)
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
11
06
2020
received:
05
12
2019
accepted:
12
06
2020
pubmed:
4
7
2020
medline:
15
12
2021
entrez:
4
7
2020
Statut:
ppublish
Résumé
Cardiac dysfunction is a common sequela in patients with sepsis and multi-organ dysfunction. Echocardiography is commonly used in the investigation of circulatory failure. We aimed to evaluate the prognostic value of echocardiographic parameters in patients with septic shock. This study was a retrospective trial. We included patients who were admitted to intensive care unit (ICU) with septic shock. The patients' echocardiograms, clinical data and outcomes were obtained from their medical records. Associations between echocardiogram variables and mortality were assessed using logistic regression, controlled for age, sex, body mass index and the interval between the ICU admission and echocardiogram. The utility of statistically significant echocardiogram variables to predict mortality were assessed using receiver operating characteristic (ROC) curves. The outcomes presented that tricuspid annular plane systolic excursion (TAPSE) was statistically significantly associated with both ICU (P = 0.02) and 90-day (P = 0.001) mortality. From the ROC curves, TAPSE emerged a significant and moderate predictor for 90-day (area under curve (AUC) = 0.69, 95% CI = 0.565-0.814) and in-ICU mortality (AUC = 0.762, 95% CI = 0.652-0.871). The optimal cut-off for TAPSE was 2.1 cm for both 90-day mortality (sensitivity of 80% and specificity and 58%) and in-ICU mortality (sensitivity of 69% and specificity of 77%). TAPSE was associated with increased mortality in those with sepsis and suspicion of cardiac dysfunction. This is a hypothesis generating article that an association may be present and requires significant more work with expansion to the entire population base.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac dysfunction is a common sequela in patients with sepsis and multi-organ dysfunction. Echocardiography is commonly used in the investigation of circulatory failure.
AIMS
OBJECTIVE
We aimed to evaluate the prognostic value of echocardiographic parameters in patients with septic shock.
METHODS
METHODS
This study was a retrospective trial. We included patients who were admitted to intensive care unit (ICU) with septic shock. The patients' echocardiograms, clinical data and outcomes were obtained from their medical records. Associations between echocardiogram variables and mortality were assessed using logistic regression, controlled for age, sex, body mass index and the interval between the ICU admission and echocardiogram. The utility of statistically significant echocardiogram variables to predict mortality were assessed using receiver operating characteristic (ROC) curves.
RESULTS
RESULTS
The outcomes presented that tricuspid annular plane systolic excursion (TAPSE) was statistically significantly associated with both ICU (P = 0.02) and 90-day (P = 0.001) mortality. From the ROC curves, TAPSE emerged a significant and moderate predictor for 90-day (area under curve (AUC) = 0.69, 95% CI = 0.565-0.814) and in-ICU mortality (AUC = 0.762, 95% CI = 0.652-0.871). The optimal cut-off for TAPSE was 2.1 cm for both 90-day mortality (sensitivity of 80% and specificity and 58%) and in-ICU mortality (sensitivity of 69% and specificity of 77%).
CONCLUSIONS
CONCLUSIONS
TAPSE was associated with increased mortality in those with sepsis and suspicion of cardiac dysfunction. This is a hypothesis generating article that an association may be present and requires significant more work with expansion to the entire population base.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1854-1861Informations de copyright
© 2020 Royal Australasian College of Physicians.
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