Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9452-9468
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9452
Incidence, prognosis, and risk factors of sepsis-induced cardiomyopathy
Yan-Wen Liang, You-Feng Zhu, Rui Zhang, Min Zhang, Xiao-Ling Ye, Jian-Rui Wei
Yan-Wen Liang, You-Feng Zhu, Rui Zhang, Xiao-Ling Ye, Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Guangzhou 510220, Guangdong Province, China
Min Zhang, Department of Geriatrics, The Affiliated Hospital of Qingdao University, Qingdao 270000, Shandong Province, China
Jian-Rui Wei, Guangzhou Women and Children’s Medical Center, Guangzhou 510000, Guangdong Province, China
Author contributions: All authors contributed to the study conception and design; Liang YW and Zhu YF contributed equally to this work and should be regarded as co-first authors; Liang YW, Zhu YF, and Zhang R performed the research; Ye XL and Zhang M collected and analyzed the data; Zhu YF, Zhang R, and Wei JR wrote the manuscript; and all authors approved the final manuscript.
Supported by Science and Technology Program of Guangzhou Science, Technology, and Innovation Commission, No. 201904010258.
Institutional review board statement: The study was reviewed and approved by the ethics committee of Guangzhou Red Cross Hospital (Approval No. AF/SC-107/02.0).
Informed consent statement: As the present study was based on the analysis of MIMICIII public database, informed consent form was waived.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: The Datasets are available from the corresponding author on reasonable request. The details of the data screening codes for our analyses, which were provided by the authors of the MIMIC-III database, can be found at GitHub (https://github.com/MIT-LCP/mimic-code).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Feng Zhu, MD, PhD, Chief Doctor, Chief Physician, Department of Intensive Care Unit, Guangzhou Red Cross Hospital, No. 396 Tongfuzhong Road, Guangzhou 510220, Guangdong Province, China. zhuyoufeng@ext.jnu.edu.cn
Received: March 27, 2021
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
Processing time: 210 Days and 8.4 Hours
ARTICLE HIGHLIGHTS
Research background

Sepsis-induced cardiomyopathy (SIC) is a complication of sepsis and septic shock. The current epidemiological studies of SIC are mainly small ones.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research 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.

Research conclusions

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.

Research perspectives

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.