Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9452
Peer-review started: March 27, 2021
First decision: May 11, 2021
Revised: May 20, 2021
Accepted: September 2, 2021
Article in press: September 2, 2021
Published online: November 6, 2021
Sepsis-induced cardiomyopathy (SIC) is a complication of sepsis and septic shock. The current epidemiological studies of SIC are mainly small ones.
At present, large-scale studies on the clinical characteristics of SIC, such as the incidence, prognosis, and risk factors, are lacking. The present study was intended to investigate these characteristics.
This study aimed to evaluate the SIC incidence rate and hospital mortality rate, as well as mechanical ventilation or renal replacement therapy use during hospital stay, the use of vasopressors (including norepinephrine, dopamine, epinephrine, and vasopressin), the length of intensive care unit (ICU) stay, and the length of hospital stay.
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 ICU and had no concomitant cardiac disease. We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results.
In the present study, we included 3530 sepsis patients. The incidence of SIC was 28.20% (95% confidence interval: 26.80%-29.70%). Compared to patients in the non-SIC group, patients in the SIC group had a significantly older age and higher SAPS-I score, SAPS-II score, and Elixhauser comorbidity index (ECI). Hospital mortality was higher in the SIC group than in the non-SIC group. 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.
Our study showed that the incidence of SIC in patients with sepsis is 28.20%. Hospital mortality is higher in the SIC patients than in the non-SIC patients.
The current study is the largest-scale study with regard to the clinical characteristics of SIC. The incidence of SIC is high. The hospital mortality is higher in the SIC group than in the non-SIC group. Clinicians should pay more attention to these patients. Further multicenter large scale studies with regard to SIC are needed.