{"id":24401,"date":"2023-08-17T04:27:00","date_gmt":"2023-08-16T20:27:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24401"},"modified":"2023-08-17T06:13:49","modified_gmt":"2023-08-16T22:13:49","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%84%9f%e6%9f%93%e6%80%a7%e4%bc%91%e5%85%8b%e6%82%a3%e8%80%85%e5%b7%a6%e5%ae%a4%e6%94%b6%e7%bc%a9%e5%8a%9f%e8%83%bd%e9%9a%9c%e7%a2%8d%e6%98%af","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24401","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u611f\u67d3\u6027\u4f11\u514b\u60a3\u8005\u5de6\u5ba4\u6536\u7f29\u529f\u80fd\u969c\u788d\u662f\u5426\u4f34\u968f\u75c5\u6b7b\u7387\u589e\u52a0"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSUE 6<\/a>, P1437-1447, JUNE 2023Download Full Issue<\/p>\n\n\n\n

Is Left Ventricular Systolic Dysfunction Associated With Increased Mortality Among Patients With Sepsis and Septic Shock?<\/h1>\n\n\n\n

Siddharth Dugar, Ryota Sato, Sanchit Chawla, et al<\/h3>\n\n\n\n

Chest 2023; 163: 1437-1447 Published:January 13, 2023<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2023.01.010<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

The impact of left ventricular (LV) systolic function on outcomes in patients with sepsis and septic shock remains uncertain. The association, if any, may be nonlinear.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Is LV systolic dysfunction associated with increased mortality among patients with sepsis and septic shock?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

Retrospective cohort study comprising all adult patients admitted to the medical ICU from January 1, 2011, through December 31, 2020, with sepsis and septic shock as defined by the Third International Consensus Definitions for Sepsis and Septic Shock guidelines. All adult patients with sepsis or septic shock who underwent transthoracic echocardiography within 3 days from admission to the medical ICU were included. We divided patients into five groups based on LV ejection fraction (LVEF). In addition to univariate analysis, we also performed multivariate logistic regression analysis adjusting for patients\u2019 baseline characteristics and severity of illness. The primary outcome was the association between each classification of LVEF and in-hospital mortality.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

A total of 3,151 patients were included in this study (LVEF\u00a0< 25%, 133 patients; 25%\u00a0\u2264 LVEF\u00a0< 40%, 305 patients; 40%\u00a0\u2264 LVEF\u00a0< 55%, 568 patients; 55%\u00a0\u2264 LVEF\u00a0< 70%, 1,792 patients; and LVEF\u00a0\u2265 70%, 353 patients). In-hospital mortalities in each LVEF category were 51.1%, 34.8%, 26.6%, 26.2%, and 41.9%, respectively. In the multivariate logistic regression analysis, LVEF of\u00a0< 25%\u00a0(OR, 2.75; 95%\u00a0CI, 1.82-4.17;\u00a0P<\/em>\u00a0< .001) and LVEF of\u00a0\u2265 70%\u00a0(OR, 1.70; 95%\u00a0CI, 1.09-1.88;\u00a0P<\/em>\u00a0= .010) were associated independently with significantly higher in-hospital mortality compared with the reference LVEF category of 55%\u00a0to 70%.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n

Interpretation<\/h3>\n\n\n\n

The association of LVEF to in-hospital mortality in sepsis and septic shock was U-shaped. Both severe LV systolic dysfunction (LVEF < 25%) and hyperdynamic LVEF (LVEF \u2265 70%) were associated independently with significantly higher in-hospital mortality.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSU […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24401"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24401"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24401\/revisions"}],"predecessor-version":[{"id":24402,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24401\/revisions\/24402"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24401"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24401"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}