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Right Ventricular Function and Long-Term Outcome in Sepsis: A Retrospective Cohort Study
Jurgen C Winkelhorst1, Inge T Bootsma1, Peter M Koetsier1
1Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Shock (Augusta, Ga.)
|July 19, 2019
Summary
Right ventricular ejection fraction (RVEF) predicts long-term mortality in severe sepsis and septic shock. Lower RVEF (<20%) is independently associated with increased 1-year all-cause mortality in these critically ill patients.
Area of Science:
- Critical Care Medicine
- Cardiology
- Sepsis Research
Background:
- Sepsis-related myocardial dysfunction impacts patient outcomes.
- Focus has traditionally been on left ventricular function.
- Prognostic significance of right ventricular dysfunction in sepsis is understudied.
Purpose of the Study:
- To investigate if right ventricular ejection fraction (RVEF) predicts long-term mortality in severe sepsis and septic shock patients.
- To assess the prognostic value of RVEF in this specific patient population.
Main Methods:
- Retrospective cohort study of 98 adult ICU patients with severe sepsis/septic shock.
- Pulmonary artery catheter used for RVEF measurement within 24 hours of admission.
- Patients categorized into RVEF groups: <20% (A), 20-30% (B), >30% (C). Primary endpoint: 1-year all-cause mortality.
Main Results:
- One-year mortality varied significantly across groups: 57% (A), 18% (B), 23% (C) (P=0.003).
- Kaplan-Meier analysis showed higher mortality in RVEF <20% group (P=0.001).
- RVEF <20% (OR 4.1) and continuous RVEF (OR 0.92) were independently associated with 1-year mortality.
Conclusions:
- Right ventricular ejection fraction is an independent predictor of 1-year mortality in severe sepsis and septic shock.
- RVEF provides crucial prognostic information beyond traditional left ventricular assessments.
- Findings highlight the importance of evaluating right ventricular function in sepsis management.
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