Koowattanatianchai Sukrisd, Kochaiyapatana Patchara, Eungsuwat Narueporn, Rangsrisaeneepitak Vimonsri, Thammakumpee Katkanit, Kaladee Kiraphol
Division of Cardiology, Department of Medicine, Burapha Hospital, Burapha University, Chonburi, Thailand.
Department of Medicine, Burapha Hospital, Burapha University, Chonburi, Thailand.
Crit Care Res Pract. 2025 Mar 14;2025:5511135. doi: 10.1155/ccrp/5511135. eCollection 2025.
This study sought to evaluate the association between right ventricular (RV) dysfunction and short-term in-hospital mortality among patients with sepsis and septic shock. A prospective cohort study was conducted on adult patients admitted at Burapha University Hospital for sepsis and septic shock from October 1, 2022, through June 30, 2023, who underwent echocardiography within 72 h after admission. RV dysfunction and other echocardiographic findings were analyzed and defined using the American Society of Echocardiography criteria. The primary outcome examined in this study was 28-day in-hospital mortality. Secondary outcomes included maximal blood lactate levels, length of intensive care unit (ICU) stay, and duration of mechanical ventilation. A total of 104 patients (mean age: 69.54 ± 14.88 years) were enrolled in this study. Among the included patients, 32 (30.8%) developed septic shock whereas 20 (19.2%) exhibited RV dysfunction. Cox regression analysis showed that patients with RV dysfunction had a 28-day in-hospital mortality rate 5.53 times higher than that of patients with normal RV function (95% confidence intervals: 1.98-15.42; =0.001). Regarding the secondary outcomes, patients with RV dysfunction exhibited a significantly higher mean serum lactate level (5.72 ± 4.96 vs. 3.74 ± 3.29 mmol/L; =0.034) and length of ICU stay (6.50 ± 2.86 vs. 2.84 ± 1.56 days; =0.020) than did those with normal RV function. RV dysfunction was associated with increased short-term mortality among patients with sepsis and septic shock. Assessing RV function among these patients facilitates precise prognostication and aids in guiding treatment strategies aimed at reducing mortality. ClinicalTrials.gov identifier: NCT06193109.
本研究旨在评估脓毒症和感染性休克患者右心室（RV）功能障碍与短期院内死亡率之间的关联。对2022年10月1日至2023年6月30日在乌汶大学医院因脓毒症和感染性休克入院且入院后72小时内接受超声心动图检查的成年患者进行了一项前瞻性队列研究。使用美国超声心动图学会标准分析并定义RV功能障碍和其他超声心动图检查结果。本研究检查的主要结局是28天院内死亡率。次要结局包括最高血乳酸水平、重症监护病房（ICU）住院时间和机械通气持续时间。本研究共纳入104例患者（平均年龄：69.54±14.88岁）。在纳入的患者中，32例（30.8%）发生感染性休克，20例（19.2%）表现出RV功能障碍。Cox回归分析显示，RV功能障碍患者的28天院内死亡率是RV功能正常患者的5.53倍（95%置信区间：1.98 - 15.42；P = 0.001）。关于次要结局，RV功能障碍患者的平均血清乳酸水平（5.72±4.96 vs. 3.74±3.29 mmol/L；P = 0.034）和ICU住院时间（6.50±2.86 vs. 2.84±1.56天；P = 0.020）显著高于RV功能正常的患者。RV功能障碍与脓毒症和感染性休克患者的短期死亡率增加相关。评估这些患者的RV功能有助于准确预后，并有助于指导旨在降低死亡率的治疗策略。ClinicalTrials.gov标识符：NCT06193109。
