Is Left Ventricular Systolic Dysfunction Associated With Increased Mortality Among Patients With Sepsis and Septic...

Area of Science:

• Cardiology
• Critical Care Medicine
• Internal Medicine

Background:

• The relationship between left ventricular (LV) systolic function and patient outcomes in sepsis and septic shock is not fully understood.
• Existing research suggests a potentially nonlinear association between LV systolic function and mortality in sepsis.

Purpose of the Study:

• To investigate the association between left ventricular ejection fraction (LVEF) and in-hospital mortality in adult patients with sepsis and septic shock.
• To determine if LV systolic dysfunction or hyperdynamic function impacts sepsis outcomes.

Main Methods:

• A retrospective cohort study included 3,151 adult patients admitted to the medical ICU with sepsis or septic shock between 2011 and 2020.
• Patients were categorized into five groups based on LVEF (<25%, 25-40%, 40-55%, 55-70%, ≥70%) and analyzed using univariate and multivariate logistic regression.
• The primary outcome was in-hospital mortality, adjusted for baseline characteristics and illness severity.

Main Results:

• In-hospital mortality rates varied significantly across LVEF groups: 51.1% (<25%), 34.8% (25-40%), 26.6% (40-55%), 26.2% (55-70%), and 41.9% (≥70%).
• Multivariate analysis revealed that LVEF <25% (OR 2.75) and LVEF ≥70% (OR 1.70) were independently associated with higher in-hospital mortality compared to the 55-70% reference group.

Conclusions:

• The association between LVEF and in-hospital mortality in sepsis and septic shock exhibits a U-shaped pattern.
• Both severely impaired LV systolic function (LVEF <25%) and hyperdynamic LV function (LVEF ≥70%) are independent predictors of increased mortality in these critically ill patients.