[Association between right ventricular function and short-term death risk in patients with sepsis].

The majority of sepsis patients developed some form of ventricular dysfunction, with isolated right ventricular dysfunction being the most common subtype.

• Among 196 patients with sepsis, 136 patients (69.4%) developed ventricular dysfunction.
• Isolated right ventricular dysfunction occurred in 50 patients (25.5%).
• Isolated left ventricular systolic dysfunction occurred in 33 patients (16.8%).
• Combined left ventricular systolic dysfunction and right ventricular dysfunction occurred in 25 patients (12.8%).
• Combined left ventricular systolic dysfunction, left ventricular diastolic dysfunction, and right ventricular dysfunction occurred in 20 patients (10.2%).

Right ventricular dysfunction occurred in nearly half of all sepsis patients and was associated with worse clinical outcomes.

• Right ventricular dysfunction occurred in 96 cases (49.0%) among 196 sepsis patients.
• Patients with right ventricular dysfunction had higher 30-day mortality compared to those without: 40.6% (39/96) vs. 21.0% (21/100), P<0.05.
• Patients with right ventricular dysfunction had higher incidence of acute renal failure: 63.5% (61/96) vs. 48.0% (48/100).
• Patients with right ventricular dysfunction had higher Lac (mmol/L): 7.8±3.4 vs. 4.2±2.3, and higher fluid resuscitation volume (mL): 2032±225 vs. 1123±115.

30-day mortality was highest in patients with isolated right ventricular dysfunction among all ventricular dysfunction subtypes.

• 30-day mortality was highest in patients with isolated right ventricular dysfunction at 36.0% (18/50).
• Patients with biventricular dysfunction had 30-day mortality of 30.4% (14/46).
• Patients with isolated left ventricular dysfunction had 30-day mortality of 22.5% (9/40).
• Patients without ventricular dysfunction had the lowest 30-day mortality at 13.8% (8/60).
• The difference across groups was statistically significant (P<0.05).

Non-survivors had significantly worse echocardiographic parameters compared to survivors, including lower TAPSE, lower right ventricular fractional area change, and lower LVEF.

• TAPSE (mm) was lower in non-survivors: 16.0±3.6 vs. 19.3±4.4, P<0.05.
• Right ventricular fractional area change was lower in non-survivors: (30.23±8.14)% vs. (33.69±7.81)%, P<0.05.
• LVEF was lower in non-survivors: 0.575±0.129 vs. 0.637±0.069, P<0.05.
• Right ventricular end-systolic area (cm²) was higher in non-survivors: 15.75±4.45 vs. 14.27±3.39, P<0.05.
• Left ventricular E/E' ratio was higher in non-survivors: 9.18±4.43 vs. 7.74±3.12, P<0.05.

Multivariate logistic regression identified right ventricular dysfunction as an independent risk factor for 30-day death in sepsis patients.

• Right ventricular dysfunction was independently associated with 30-day mortality: OR=2.34, 95%CI 1.21–3.78, P<0.05.
• Left ventricular diastolic dysfunction was also an independent risk factor: OR=2.35, 95%CI 1.09–5.18, P<0.05.
• Mechanical ventilation had the highest OR among independent risk factors: OR=92.45, 95%CI 34.67–369.45.
• Higher vasoactive drug dose was independently associated with mortality: OR=65.45, 95%CI 19.88–195.83.
• Higher Lac was independently associated with mortality: OR=13.44, 95%CI 6.15–25.35; higher APACHE II score: OR=1.35, 95%CI 1.21–1.65; and CRRT: OR=2.43, 95%CI 0.25–0.64.

Non-survivors differed from survivors on multiple clinical parameters beyond echocardiographic measures.

• Non-survivors had less urine output, higher proportion receiving CRRT, higher APACHE II scores, higher Lac levels, higher vasoactive drug doses, and higher proportion requiring mechanical ventilation compared to survivors.
• The study was a retrospective cohort of 196 adult sepsis patients admitted to critical care medicine from January 2020 to December 2023.
• Of 196 patients, 157 survived to 30 days and 39 died.