Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock
Background: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pa...
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| Language: | English |
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Interna Publishing
2019-05-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | https://actamedindones.org/index.php/ijim/article/view/518 |
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| author | Pudjo Rahasto BUdhi Setianto Ina S Timan Suhendro Suhendro Lugyanti Sukrisman Renan Sukamawan Mondastri K Sudaryo Peter Kabo |
| author_facet | Pudjo Rahasto BUdhi Setianto Ina S Timan Suhendro Suhendro Lugyanti Sukrisman Renan Sukamawan Mondastri K Sudaryo Peter Kabo |
| author_sort | Pudjo Rahasto |
| collection | DOAJ |
| description | Background: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pathophysiology of cardiovascular disorder in patients with septic shock. This study aimed to evaluate the roles of echocardiography, cardiovascular biomarkers, venous oxygen saturation and renal function as predictors of mortality rate in patients with septic shock. Methods: this is a prospective cohort study in patients with infections, hypotension (MAP < 65 mmHg) and serum lactate level of > 2 mmol/L. On the first and fifth days, septic patients underwent echocardiography and blood tests. Statistical analysis used in our study included t-test or Mann-Whitney test for numeric data and chi-square test for nominal data of two-variable groups; while for multivariate analysis, we used Cox Regression model. Results: on 10 days of observation, we found 64 (58%) patients died and 47 (42%) patients survived. The mean age of patients was 48 (SD 18) years. Patients with abnormal left ventricular ejection fraction (LVEF) had 1.6 times greater risk of mortality than those with normal LVEF (RR 1.6; p = 0.034). Patients with abnormal troponin I level showed higher risk of mortality as many as 1.6 times (RR: 1.6; p = 0.004). Patients with impaired renal function had 1.5 times risk of mortality (RR 1.5; p = 0.024). Patients with abnormal troponin I level and/or impaired renal function showed increased mortality risk; however, those with normal troponin I level and impaired renal function also showed increased mortality risk. Multivariate analysis revealed that left ventricular ejection fraction and troponin I level may serve as predictors of mortality in patients with septic shock. (HR 1.99; 95% CI: 1.099 ̶ 3.956 ; p = 0.047 and HR: 1.83 ; 95%CI: 1.049 ̶ 3,215 ; p = 0.043). Conclusion: left ventricular ejection fraction and biomarkers such as troponin I level are predictors of mortality in septic shock patients. |
| format | Article |
| id | doaj-art-c4ee915c5fb146c3b0c87957ac2a6ea8 |
| institution | DOAJ |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | Interna Publishing |
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| series | Acta Medica Indonesiana |
| spelling | doaj-art-c4ee915c5fb146c3b0c87957ac2a6ea82025-08-20T03:13:54ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322019-05-01511301Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic ShockPudjo Rahasto0BUdhi Setianto1Ina S Timan2Suhendro Suhendro3Lugyanti Sukrisman4Renan Sukamawan5Mondastri K Sudaryo6Peter Kabo7Medical Staff of Cardiology and Vascular Division, Tangerang District General Hospital, Banten, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Clinical Pathology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaFaculty of Public Health, Universitas Indonesia, Jakarta, IndonesiaDepartment of Cardiovascular Medicine, Faculty of Medicine Universitas Hasanuddin, Makasar, IndonesiaBackground: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pathophysiology of cardiovascular disorder in patients with septic shock. This study aimed to evaluate the roles of echocardiography, cardiovascular biomarkers, venous oxygen saturation and renal function as predictors of mortality rate in patients with septic shock. Methods: this is a prospective cohort study in patients with infections, hypotension (MAP < 65 mmHg) and serum lactate level of > 2 mmol/L. On the first and fifth days, septic patients underwent echocardiography and blood tests. Statistical analysis used in our study included t-test or Mann-Whitney test for numeric data and chi-square test for nominal data of two-variable groups; while for multivariate analysis, we used Cox Regression model. Results: on 10 days of observation, we found 64 (58%) patients died and 47 (42%) patients survived. The mean age of patients was 48 (SD 18) years. Patients with abnormal left ventricular ejection fraction (LVEF) had 1.6 times greater risk of mortality than those with normal LVEF (RR 1.6; p = 0.034). Patients with abnormal troponin I level showed higher risk of mortality as many as 1.6 times (RR: 1.6; p = 0.004). Patients with impaired renal function had 1.5 times risk of mortality (RR 1.5; p = 0.024). Patients with abnormal troponin I level and/or impaired renal function showed increased mortality risk; however, those with normal troponin I level and impaired renal function also showed increased mortality risk. Multivariate analysis revealed that left ventricular ejection fraction and troponin I level may serve as predictors of mortality in patients with septic shock. (HR 1.99; 95% CI: 1.099 ̶ 3.956 ; p = 0.047 and HR: 1.83 ; 95%CI: 1.049 ̶ 3,215 ; p = 0.043). Conclusion: left ventricular ejection fraction and biomarkers such as troponin I level are predictors of mortality in septic shock patients.https://actamedindones.org/index.php/ijim/article/view/518echocardiographydeathNT Pro BNPseptic shocktroponin I |
| spellingShingle | Pudjo Rahasto BUdhi Setianto Ina S Timan Suhendro Suhendro Lugyanti Sukrisman Renan Sukamawan Mondastri K Sudaryo Peter Kabo Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock Acta Medica Indonesiana echocardiography death NT Pro BNP septic shock troponin I |
| title | Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock |
| title_full | Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock |
| title_fullStr | Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock |
| title_full_unstemmed | Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock |
| title_short | Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock |
| title_sort | cardiac performance by echocardiography cardiovascular biomarker kidney function and venous oxygen saturation as mortality predictors of septic shock |
| topic | echocardiography death NT Pro BNP septic shock troponin I |
| url | https://actamedindones.org/index.php/ijim/article/view/518 |
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