Sepsis-associated myocardial injury: Incidence and mortality

The incidence and mortality associated with sepsis myocardial injury (SAMI) remain understudied. We aimed to explore whether the 4 myocardial injury markers (MIMs) scores in the Intensive Care Units (ICU) were associated with the incidence and mortality of patients with SAMI. A retrospective study collected data from 316 adult SAMI patients who underwent MIMs tests on the ICU (January 1, 2017-January 1, 2020) of the Shuyang Hospital in China, and the predictors of mortality were determined using multivariable Cox models. Between January 1, 2017 and January 1, 2020, 316 (61.1 %) adults were diagnosed with SAMI in a consecutive sample of 517 admissions. A total of 177 (56.0%) patients with SAMI died at 28 days follow-up, and its initial (24 hours) MIMs score, highest MIMs scores (>80 hours), sepsis-associated organ failure assessment (SOFA) score, systemic inflammatory response syndrome (SIIRS) point, and inflammation markers were significantly different between the survival and non-survival group (all P < .05). We found that a initial elevated MIMs score (hazard ratios [HR], 6.4; 95% CI = 4.298-11.48), high SIRS point (HR, 3.2; 95% CI = 1.249-5.115), high SOFA score (HR, 3.6; 95% CI = 1.315-5.974), and highest MIMs score (HR, 6.8; 95% CI = 4.379-11.53) were associated with high mortality for SAMI. The area under the ROC curve for mortality of SAMI was significantly larger for the highest MIMs score (0.88, 95% CI = 0.85-0.96) than for the initial MIMs score (0.84, 95% CI = 0.80-0.87) (P < .001). High MIMs scores in SAMI was associated with high mortality, suggesting that a greater need to predict outcomes and active treatment SAMI to reduce mortality, in addition to timely antibiotic treatment.