Liang Yan-Wen, Zhu You-Feng, Zhang Rui, Zhang Min, Ye Xiao-Ling, Wei Jian-Rui
Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Guangzhou 510220, Guangdong Province, China.
Department of Geriatrics, The Affiliated Hospital of Qingdao University, Qingdao 270000, Shandong Province, China.
World J Clin Cases. 2021 Nov 6;9(31):9452-9468. doi: 10.12998/wjcc.v9.i31.9452.
At present, large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy (SIC) are lacking.
To investigate the clinical characteristics of SIC.
Based on the analysis of the MIMIC-III public database, we performed a large-scale retrospective study involving sepsis patients who were admitted to the intensive care unit (ICU) and had no concomitant cardiac disease. We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results. The primary outcome was hospital mortality, and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay, the number of patients administered with vasopressors, the length of ICU stay, and the length of hospital stay.
In the present study, after screening 38605 patients, 3530 patients with sepsis were included. A total of 997 patients met the SIC diagnostic criteria, and the incidence of SIC was 28.20% (95% confidence interval [CI]: 26.80%-29.70%). Compared to patients in the non-SIC group, patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score (SAPS)-I score, SAPS-II score, and Elixhauser comorbidity index (ECI). A total of 367 (36.8%) of 997 patients in the SIC group and 818 (32.3%) of 2533 patients in the non-SIC group died in the hospital, which resulted in a significant between-group difference (odds ratios = 1.22, 95%CI: 1.05-1.42; = 0.011). For the secondary outcomes, more patients in the SIC group received mechanical ventilation and vasopressors. Multivariate logistic regression analysis showed that age, male sex, ECI, hemoglobin level, diabetes, and mechanical ventilation use on the first day of ICU admission were risk factors for SIC.
Compared with non-SIC patients, hospital mortality is higher in SIC patients.
目前，关于脓毒症诱导的心肌病（SIC）临床特征的大规模研究尚缺乏。
探讨SIC的临床特征。
基于对MIMIC-III公共数据库的分析，我们进行了一项大规模回顾性研究，纳入入住重症监护病房（ICU）且无合并心脏病的脓毒症患者。我们采用倾向评分匹配分析和多因素逻辑回归以确保结果的稳健性。主要结局为住院死亡率，次要结局包括住院期间接受机械通气或肾脏替代治疗的患者数量、使用血管升压药的患者数量、ICU住院时长及住院时长。
在本研究中，经筛选38605例患者后，纳入3530例脓毒症患者。共有997例患者符合SIC诊断标准，SIC发病率为28.20%（95%置信区间[CI]：26.80% - 29.70%）。与非SIC组患者相比，SIC组患者年龄更大，且简化急性生理学评分（SAPS）-I、SAPS-II评分及埃利克斯豪泽合并症指数（ECI）更高。SIC组997例患者中有367例（36.8%）、非SIC组2533例患者中有818例（32.3%）在医院死亡，组间差异有统计学意义（比值比 = 1.22，95%CI：1.05 - 1.42；P = 0.011）。对于次要结局，SIC组更多患者接受了机械通气和血管升压药治疗。多因素逻辑回归分析显示，年龄、男性、ECI、血红蛋白水平、糖尿病及入住ICU首日使用机械通气是SIC的危险因素。
与非SIC患者相比，SIC患者的住院死亡率更高。
