Analysis of incidence and risk factors of septic cardiomyopathy / 中华急诊医学杂志

ABSTRACT

Objective To investigate the incidence and risk factors of septic cardiomyopathy,and to provide evidence for the diagnosis,treatment and prevention of septic cardiomyopathy.Methods Totally 208 patients with septic or septic shock (≥ 18 years old) were admitted to ICU Department of The First Hospital of Jilin University from January 2015 to August 2017.The clinical data of all patients were retrospectively analyzed,and the baseline data and clinical outcomes were compared between the septic cardiomyopathy group (39 cases) and non-septic cardiomyopathy group (169 cases).Multiple Logistic regression analysis was used to analyze the risk factors of septic cardiomyopathy.Results (1) The incidence of septic cardiomyopathy in patients with septic or septic shock was about 18.8％.(2) There was no significant difference in baseline body weight,atrial fibrillation,hypertension,diabetes,malignant tumor,maximum body temperature,blood leukocyte,C-reactive protein(CRP),procalcitonin(PCT),positive blood culture,in-hospital mortality and 30-day mortality between the two groups (all P＞0.05).Age (P=0.01),sex (P=0.02),history of heart failure (P=0.03),history of coronary heart disease (P=0.01),platelet at ICU admission (P=0.01),lactic acid at ICU admission (P=0.02),vasoactive drugs (P=0.03),APACHE Ⅱ score (P=0.03),SOFA score (P=0.01),and ICU length of hospital stay (P=0.03) were significantly different between the two groups.(3) Patients with a history of heart failure (OR=1.55,95％CI0.73-1.66;P=0.01),a history of coronary heart disease (OR=1.18,95％CI1.03-1.66;P=0.03),and lactic acid at ICU admission ＞ 4.0 mmol/L (OR=1.10,95％CI1.00-1.30;P=0.04) were independent risk factors for the incidence of septic cardiomyopathy.Conclusion Septic cardiomyopathy has a relatively high incidence in patients with septic or septic shock.Patients with a history of heart failure,a history of coronary heart disease and lactic acid at ICU admission ＞ 4.0 mmol/L are independent risk factors for the incidence of septic cardiomyopathy.