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Predictors and outcomes of sepsis-induced cardiomyopathy in critically ill patients

机译：患有患者的败血症诱导心肌病的预测因子和结果

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Background:Sepsis-induced cardiomyopathy (SIC) occurs frequently in critically ill patients, but the clinical features and prognostic impact of SIC on sepsis outcome remain controversial. Here, we investigated the predictors and outcomes of SIC.Methods:Patients admitted to a single medical intensive care unit from June 2016 to September 2017 were retrospectively reviewed. SIC was diagnosed by ejection fraction (EF) 50% and ≥10% decrease in baseline EF that recovered within 2 weeks.Results:In total, 342 patients with sepsis met the inclusion criteria, and 49 patients (14.3%) were diagnosed with SIC; the latter were compared with 259 patients whose EF was not deteriorated by sepsis (non-SIC). Low systolic blood pressure and increased left ventricular end-diastolic diameter (LVEDD) were identified as predictors of SIC. SIC and non-SIC patients did not differ significantly in terms of 28-day all-cause mortality (24.5% vs. 26.3%, P=0.936). Acute Physiology and Chronic Health Evaluation II (APACHE II; hazard ratio [HR], 1.10; 95% confidential interval [CI], 1.02-1.18; P=0.009) and delta neutrophil index (DNI; HR, 1.02; 95% CI, 1.00-1.08; P=0.026) were independent risk factors for 28-day mortality with SIC. DNI, APACHE II, and lactate were identified as risk factors for 28-day mortality in sepsis patients as a whole.Conclusion:: SIC was not associated with increased mortality compared to non-SIC. Low systolic blood pressure and increased LVEDD were predictors of SIC. High APACHE II score and elevated DNI, which reflect sepsis severity, predict 28-day all-cause mortality.
机译：背景：脓毒症诱导的心肌病（SIC）经常发生在危重病人身上，但SIC对SEPSIS结果的临床特征和预后影响仍存在争议。在这里，我们调查了SiC.Methods的预测因子和结果：回顾性地审查了2016年6月至2017年9月的单一医学密集护理单位的患者。通过喷射部分（EF）被诊断出来的基线EF诊断的SiC，在2周内恢复的基线EF减少。结果：总共342名败血症患者符合含有标准，49名患者（14.3％）被诊断出来SIC;将后者与259名患者进行比较，因为败血症（非SiC）不会恶化。收缩压和左心室末端 - 舒张直径增加（LVEDD）被鉴定为SiC的预测因子。 SIC和非SIC患者在28天的全因死亡率方面没有显着差异（24.5％与26.3％，P = 0.936）。急性生理学和慢性健康评估II（Apache II;危害比[HR]，1.10; 95％机密间隔[CI]，1.02-1.18; P = 0.009）和DELTA中性粒细胞指数（DNI; HR，1.02; 95％CI， 1.00-1.08; P = 0.026）是28天死亡率的独立危险因素。鉴定DNI，Apache II和乳酸症作为脓毒症患者的28天死亡率的危险因素。结论:: SIC与非SIC相比的死亡率没有增加。低收缩压和增加的LVEDD是SIC的预测因子。高阿皮奇II分数和升高的DNI，反映了败血症严重程度，预测了28天的全导致死亡率。

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