Serial TAPSE and Subsequent 60-Day Mortality Among Critically Ill Adults with Reduced Baseline TAPSE: A MIMIC-IV-ECHO
Shanshan Zhai1, Dezhi Ren1, Yongyi Chen1
1Department of Intensive Care Unit, China-Japan Friendship Hospital, Beijing 100029, China.
Abstract:
Background/Objectives: Tricuspid annular plane systolic excursion (TAPSE) is routinely available in critical-care echocardiography, but the prognostic relevance of serial change is uncertain. We examined serial TAPSE and subsequent mortality among critically ill adults with reduced baseline TAPSE. Methods: This retrospective MIMIC-IV-ECHO cohort included adults with at least two TAPSE measurements and baseline TAPSE < 1.7 cm. Serial TAPSE status was classified as improved (increase >0.2 cm) or non-improved (change ≤0.2 cm). Cox regression evaluated 60-day mortality from the follow-up echocardiogram. Results: Among 227 patients, 101 (44.5%) were improved and 126 (55.5%) non-improved over a median interval of 10 days. Non-improved status was associated with higher subsequent mortality (adjusted hazard ratio 1.72, 95% confidence interval 1.06-2.80; p = 0.028). After adjustment for follow-up TAPSE, neither binary status nor continuous change was significantly associated with mortality. Conclusions: In this exploratory study, non-improved serial TAPSE was associated with higher 60-day mortality. Added prognostic value beyond follow-up TAPSE was not demonstrated.
