Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.

<h4>Introduction</h4>Septic shock is a severe form of sepsis that has a high mortality rate, and a substantial proportion of these patients will develop cardiac dysfunction, often termed septic cardiomyopathy (SCM). Some SCM patients may develop frank cardiac failure, termed sepsis-relat...

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Main Authors: Kathryn W Hendrickson, Meghan M Cirulis, Rebecca E Burk, Michael J Lanspa, Ithan D Peltan, Hunter Marshall, Danielle Groat, Al Jephson, Sarah J Beesley, Samuel M Brown
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0299876
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author Kathryn W Hendrickson
Meghan M Cirulis
Rebecca E Burk
Michael J Lanspa
Ithan D Peltan
Hunter Marshall
Danielle Groat
Al Jephson
Sarah J Beesley
Samuel M Brown
author_facet Kathryn W Hendrickson
Meghan M Cirulis
Rebecca E Burk
Michael J Lanspa
Ithan D Peltan
Hunter Marshall
Danielle Groat
Al Jephson
Sarah J Beesley
Samuel M Brown
author_sort Kathryn W Hendrickson
collection DOAJ
description <h4>Introduction</h4>Septic shock is a severe form of sepsis that has a high mortality rate, and a substantial proportion of these patients will develop cardiac dysfunction, often termed septic cardiomyopathy (SCM). Some SCM patients may develop frank cardiac failure, termed sepsis-related cardiogenic shock (SeRCS). Little is known of SeRCS. This study describes baseline characteristics of patients with SCM and SeRCS compared to patients with septic shock without cardiac dysfunction. We compare clinical outcomes among SCM, SeRCS, and septic shock, and identify risk factors for the development of SCM and SeRCS.<h4>Methods</h4>Septic patients admitted to the ICU with an echocardiogram obtained within 72 hours were included. Left ventricular ejection fraction of ≤55% was used to define SCM, and cardiac index ≤2.1 L/min/m2 among patients with SCM defined SeRCS. Machine learning was used to identify risk factors for development of SCM and SeRCS. Logistic regression was used to compare mortality among groups.<h4>Results</h4>Among 1229 patients, 977 patients had septic shock without cardiac dysfunction, 207 had SCM, and 45 had SeRCS. In patients with septic shock, the strongest predictor for developing SCM and SeRCs was a prior history of cardiac dysfunction. Mortality did not significantly differ among the three groups.<h4>Conclusions</h4>SCM and SeRCS affect a minority of patients with septic shock, disproportionately affecting individuals with a history of cardiac disease. We did not identify a mortality difference associated with SCM or SeRCS. Additional work is needed to define further subtypes and treatment options for this patient population.
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spelling doaj-art-8b2afe9580884cdc85f1ddb72bc8368b2025-08-20T03:16:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01194e029987610.1371/journal.pone.0299876Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.Kathryn W HendricksonMeghan M CirulisRebecca E BurkMichael J LanspaIthan D PeltanHunter MarshallDanielle GroatAl JephsonSarah J BeesleySamuel M Brown<h4>Introduction</h4>Septic shock is a severe form of sepsis that has a high mortality rate, and a substantial proportion of these patients will develop cardiac dysfunction, often termed septic cardiomyopathy (SCM). Some SCM patients may develop frank cardiac failure, termed sepsis-related cardiogenic shock (SeRCS). Little is known of SeRCS. This study describes baseline characteristics of patients with SCM and SeRCS compared to patients with septic shock without cardiac dysfunction. We compare clinical outcomes among SCM, SeRCS, and septic shock, and identify risk factors for the development of SCM and SeRCS.<h4>Methods</h4>Septic patients admitted to the ICU with an echocardiogram obtained within 72 hours were included. Left ventricular ejection fraction of ≤55% was used to define SCM, and cardiac index ≤2.1 L/min/m2 among patients with SCM defined SeRCS. Machine learning was used to identify risk factors for development of SCM and SeRCS. Logistic regression was used to compare mortality among groups.<h4>Results</h4>Among 1229 patients, 977 patients had septic shock without cardiac dysfunction, 207 had SCM, and 45 had SeRCS. In patients with septic shock, the strongest predictor for developing SCM and SeRCs was a prior history of cardiac dysfunction. Mortality did not significantly differ among the three groups.<h4>Conclusions</h4>SCM and SeRCS affect a minority of patients with septic shock, disproportionately affecting individuals with a history of cardiac disease. We did not identify a mortality difference associated with SCM or SeRCS. Additional work is needed to define further subtypes and treatment options for this patient population.https://doi.org/10.1371/journal.pone.0299876
spellingShingle Kathryn W Hendrickson
Meghan M Cirulis
Rebecca E Burk
Michael J Lanspa
Ithan D Peltan
Hunter Marshall
Danielle Groat
Al Jephson
Sarah J Beesley
Samuel M Brown
Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
PLoS ONE
title Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
title_full Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
title_fullStr Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
title_full_unstemmed Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
title_short Identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis-related cardiogenic shock: A retrospective, observational study.
title_sort identifying predictors and determining mortality rates of septic cardiomyopathy and sepsis related cardiogenic shock a retrospective observational study
url https://doi.org/10.1371/journal.pone.0299876
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