初始左心室缩功能障碍与败血症临床结果之间的关联:一个多中心队列研究
Hyunseung Nam1, Ji Hyun Cha1, Ki Hong Choi2
1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Critical care medicine
|July 2, 2025
概括
在败血症患者中,严重的左心室 (LV) 缩功能障碍显著增加了住院死亡率,特别是在细菌病或没有先前心血管疾病的情况下. 早期的心脏评估对于败血症管理至关重要.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染的反应失调引起的.
- 左心室 (LV) 缩功能障碍是败血症的一个常见并发症.
- LV 功能障碍严重程度对败血症临床结果的影响需要进一步调查.
研究的目的:
- 检查 LV 缩功能障碍的严重程度与败血症患者的临床结果之间的关联.
- 特别关注住院死亡率作为主要结果.
主要方法:
- 一项多中心队列研究,涉及来自韩国19家医院的2274名成人败血症患者.
- 心声检查在体质认定后的24小时内进行,以评估LV射出分数 (LVEF).
- 患者被分为正常 (>50%),轻度至中度 (30-50%) 和严重 (<30%) 的LVEF组.
主要成果:
- 住院死亡率为25.73% (正常的LVEF),29.49% (轻度至中度) 和40.00% (严重的LVEF) (p=0.023).
- 在倾向性得分匹配后,严重的LV功能障碍与增加的住院死亡率 (aOR 1.81) 独立相关.
- 这种关联在没有先前存在心血管疾病的患者和患有细菌病的患者中更为强烈.
结论:
- 严重的LV静脉缩功能障碍 (LVEF<30%) 是败血症医院死亡率增加的重要预测因素.
- 细菌病的存在和没有先前存在的心血管疾病加剧了这种风险.
- 在败血症中早期评估心脏功能至关重要,因为感染状况和心血管健康影响结果.
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