Epidemiology and Risk Factors of Sepsis and Sepsis-Induced Myocardial Dysfunction in the Intensive Care Units of...

Sepsis and sepsis-induced myocardial depression (SIMD) are critical conditions associated with high mortality in intensive care units (ICUs). This study aimed to characterize the clinical profiles of sepsis and SIMD in tertiary ICUs, identify prognostic determinants, and enhance understanding of outcome-related risk factors. We conducted a multicenter observational study involving sepsis patients admitted to 30 tertiary ICUs in Hebei Province, China, between May and September 2016. Each patient underwent echocardiography, with left ventricular ejection fraction measured via Simpson's method to assess myocardial dysfunction. Comprehensive clinical data were collected and analyzed. Among 4,897 enrolled patients, sepsis prevalence was 31.48%, with a 28-day mortality rate of 27.40%. Among them, 486 patients had septic shock, with a prevalence of 9.39% and 28-day mortality of 50.41%, and 234 had sepsis-induced myocardial depression, with a prevalence of 4.79% and 28-day mortality of 42.31%. Univariate analysis identified significant associations between survival outcomes and age, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment score, Multiple Organ Dysfunction Syndrome, left ventricular ejection fraction, lactate, white blood cell, procalcitonin (PCT), and C-reactive protein. Multivariate analysis demonstrated that age, APACHE II score, lactate, and PCT were independent risk factors for sepsis mortality, while APACHE II score and PCT independently predicted mortality in SIMD patients. The lungs and abdomen were the most common infection sites. Prognostic stratification should prioritize APACHE II score and PCT, which were consistent independent risk factors for both sepsis and SIMD.