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Research Article
Daisuke Kasugai
Nagoya University
Corresponding Author
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This study retrospectively analyzed data from the Medical Information Mart for Intensive Care-III critical care database to determine whether visually-assessed right ventricular (RV) dysfunction was associated with clinical outcomes in septic shock patients. Associations between visually-assessed RV dysfunction by echocardiography and in-hospital mortality, lethal arrhythmia, and hemodynamic indicators to determine the prognostic value of RV dysfunction in patients with septic shock were analyzed. Propensity score analysis showed RV dysfunction increased risk of in-hospital death in patients with septic shock (adjusted odds ratio [OR], 2.15; 95% confidence interval [CI], 1.99–2.32; P<0.0010. In multivariate logistic regression analysis, RV dysfunction was associated with in-hospital death (OR, 2.19; 95%CI, 1.91–2.53; P<0.001), lethal arrhythmia (OR, 2.19; 95%CI, 1.34–3.57; P<0.001), and tendency for increased blood lactate levels (OR, 1.31; 95%CI, 1.14–1.50; P<0.001) independent of left ventricular (LV) dysfunction. RV dysfunction patients had lower cardiac output, pulmonary artery pressure index, and RV stroke work index than those without RV dysfunction. In patients with septic shock, visually-assessed RV dysfunction was associated with in-hospital mortality, lethal arrhythmia, and circulatory insufficiency independent of LV dysfunction. Visual assessment of RV dysfunction using echocardiography might predict the short-term prognosis of patients with septic shock by reflecting hemodynamic status.
Keywords
Septic shock, Septic cardiomyopathy, Right ventricular function, Echocardiography, Prognosis
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Daisuke Kasugai
Nagoya University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 04 Mar, 2021
No community comments so far
Reviewers invited
Invitations sent on 10 Apr, 2021
Editor assigned
On 10 Apr, 2021
Editor invited
On 24 Feb, 2021
Submission checks complete
On 24 Feb, 2021
First submitted
On 20 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
This study retrospectively analyzed data from the Medical Information Mart for Intensive Care-III critical care database to determine whether visually-assessed right ventricular (RV) dysfunction was associated with clinical outcomes in septic shock patients. Associations between visually-assessed RV dysfunction by echocardiography and in-hospital mortality, lethal arrhythmia, and hemodynamic indicators to determine the prognostic value of RV dysfunction in patients with septic shock were analyzed. Propensity score analysis showed RV dysfunction increased risk of in-hospital death in patients with septic shock (adjusted odds ratio [OR], 2.15; 95% confidence interval [CI], 1.99–2.32; P<0.0010. In multivariate logistic regression analysis, RV dysfunction was associated with in-hospital death (OR, 2.19; 95%CI, 1.91–2.53; P<0.001), lethal arrhythmia (OR, 2.19; 95%CI, 1.34–3.57; P<0.001), and tendency for increased blood lactate levels (OR, 1.31; 95%CI, 1.14–1.50; P<0.001) independent of left ventricular (LV) dysfunction. RV dysfunction patients had lower cardiac output, pulmonary artery pressure index, and RV stroke work index than those without RV dysfunction. In patients with septic shock, visually-assessed RV dysfunction was associated with in-hospital mortality, lethal arrhythmia, and circulatory insufficiency independent of LV dysfunction. Visual assessment of RV dysfunction using echocardiography might predict the short-term prognosis of patients with septic shock by reflecting hemodynamic status.
Figure 1
Figure 2
Figure 3
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