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Observational Study
. 2024 Apr 25;19(4):e0299876.
doi: 10.1371/journal.pone.0299876. eCollection 2024.

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

Kathryn W Hendrickson  1 , Meghan M Cirulis  2   3 , Rebecca E Burk  4 , Michael J Lanspa  2   3 , Ithan D Peltan  2   3 , Hunter Marshall  3 , Danielle Groat  2   5 , Al Jephson  2   5 , Sarah J Beesley  2   3 , Samuel M Brown  2   3
Affiliations
Observational Study

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

Kathryn W Hendrickson et al. PLoS One. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow of patients into the study cohort.
Fig 2
Fig 2. Data analysis pipeline and machine learning algorithms to identify risk factors for development of SCM and SeRCS.
See this image and copyright information in PMC

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