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Multicenter Study
. 2022 Jun:69:154013.
doi: 10.1016/j.jcrc.2022.154013. Epub 2022 Mar 9.

Early echocardiography by treating physicians and outcome in the critically ill: An ancillary study from the prospective multicenter trial FROG-ICU

Koji Takagi  1 , Eiichi Akiyama  2 , Alexis Paternot  3 , Òscar Miró  4 , Cyril Charron  3 , Etienne Gayat  5 , Nicolas Deye  6 , Alain Cariou  7 , Xavier Monnet  8 , Samir Jaber  9 , Bertrand Guidet  10 , Charles Damoisel  11 , Romain Barthélémy  11 , Elie Azoulay  12 , Antoine Kimmoun  13 , Marie-Céline Fournier  5 , Bernard Cholley  14 , Christopher Edwards  15 , Beth A Davison  1 , Gad Cotter  1 , Antoine Vieillard-Baron  3 , Alexandre Mebazaa  16
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Free article
Multicenter Study

Early echocardiography by treating physicians and outcome in the critically ill: An ancillary study from the prospective multicenter trial FROG-ICU

Koji Takagi et al. J Crit Care. 2022 Jun.
Free article

Abstract

Purpose: This study aimed to investigate the association between the use of early echocardiography performed by the treating physician certified in critical care ultrasound and mortality in ICU patients.

Materials and methods: FROG-ICU was a multi-center cohort designed to investigate the outcome of critically ill patients. Of the 1359 patients admitted to centers where echocardiography was available, 372 patients underwent echocardiography during the initial 3 days.

Results: Of the ICU patients admitted for cardiac disease, 47.4% underwent echocardiography, and those patients had the lowest left ventricular ejection fraction 40 [31-58] % and the lowest cardiac output 4.2 [3.2-5.7] L/min compared to patients admitted for other causes (p < 0.001 for both). One-year mortality was 36.8% and 39.9% in patients with and without echocardiography, respectively [HR 0.92 (95% CI 0.75-1.11)]. This result was confirmed after multivariable Cox regression analysis [HR 0.88 (95% CI 0.71-1.08)]. Subgroup analyses suggest that among patients admitted to ICU for cardiac disease, those managed with echocardiography had a lower risk of one-year mortality [HR 0.65 (95% CI 0.43-0.98)].

Conclusions: Early echocardiography by treating physicians was not associated with short- or long-term survival in ICU patients. In subgroups, early echocardiography improved survival in ICU patients admitted for cardiac disease.

Trial registration: clinicaltrials.gov Identifier: NCT01367093.

Keywords: Critically ill; Echocardiography; ICU; Mortality.

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Conflict of interest statement

Declaration of Competing Interest KT received speaker's honoraria from Otsuka, Sumitomo Dainippon, AstraZeneca, and Bayer and consultancy fees from Terumo. AK received speaker's honoraria from Baxter, MSD, Gilead. EG received research grant from Sphingotec and consultancy fees from Magnisense and Roche Diagnostics. CE is an employee of Momentum Research who received research grants from Abbott Laboratories, Amgen, Celyad, Cirius Therapeutics, Roche Diagnostics, Sanofi, and Windtree Therapeutics Inc. BD is an employee of Momentum Research who received research grants from Abbott Laboratories, Amgen, Celyad, Cirius Therapeutics, Roche Diagnostics, Sanofi, and Windtree Therapeutics Inc. GC is an employee of Momentum Research who received research grants from Abbott Laboratories, Amgen, Celyad, Cirius Therapeutics, Roche Diagnostics, Sanofi, and Windtree Therapeutics Inc. AV declares research grant from GSK company. AM reports personal fees from Novartis, Orion, Roche, Servier, Sanofi, Otsuka, Philips, grants and personal fees from Adrenomed, Abbott, as well as grants from 4TEEN4. The other authors declared no potential conflicts of interest with respect to the research authorship and/or publication of this article.

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