Elevated modified shock index in early sepsis is associated with myocardial dysfunction and mortality

Area of Science:

• Cardiology
• Critical Care Medicine
• Sepsis Research

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• Myocardial dysfunction is a common complication of sepsis, associated with increased mortality.
• Early identification of patients at risk for myocardial dysfunction is crucial for timely intervention.

Purpose of the Study:

• To investigate the association between an elevated modified shock index (MSI) and myocardial dysfunction in patients with severe sepsis or septic shock.
• To determine if MSI can predict myocardial depression, mortality, and SOFA scores in sepsis.

Main Methods:

• A retrospective cohort study of 578 adults admitted to the medical intensive care unit with severe sepsis or septic shock (2011-2014).
• Modified shock index (MSI) > 1.3 within the first 6 hours was assessed.
• Logistic regression analysis was used to evaluate associations with myocardial dysfunction, depression, mortality, and SOFA scores, adjusted for relevant covariates.

Main Results:

• An elevated MSI (>1.3) was associated with increased odds of myocardial dysfunction (OR 1.10) and myocardial depression (OR 1.28).
• MSI was also significantly associated with increased ICU mortality (OR 1.17), hospital mortality (OR 1.13), and higher SOFA scores.
• 29% of patients developed myocardial dysfunction and 4% developed myocardial depression.

Conclusions:

• An elevated modified shock index during early sepsis is a significant predictor of myocardial dysfunction and depression.
• MSI serves as a valuable early warning marker for adverse cardiac outcomes and mortality in sepsis patients.
• These findings support the utility of MSI in risk stratification and management of sepsis.