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Tricuspid Annular Plane Systolic Excursion is a Predictor of Mortality for Septic Shock.
Intern Med J. 2020 Jul 02 [Online ahead of print]IM

Abstract

OBJECTIVE

Cardiac dysfunction is a common sequela in patients with sepsis and multi-organ dysfunction. Echocardiography is commonly used in the investigation of circulatory failure. We aimed to evaluate the prognostic value of echocardiographic parameters in patients with septic shock.

METHODS

This study was a retrospective trial. We included patients who were admitted to ICU with septic shock. The patients' echocardiograms, clinical data, and outcomes were obtained from their medical records. Associations between echo-cardiogram variables and mortality were assessed using logistic regression, controlled for age, sex, BMI, and the interval between the ICU admission and echocardiogram. The utility of statistically significant echocardiogram variables to predict mortality were assessed using receiver operating characteristic (ROC) curves.

RESULTS

The outcomes presented that Tricuspid Annular Plane Systolic Excursion(TAPSE) was statistically significantly associated with both ICU (p = 0.02) and 90-day (p = 0.001) mortality. From the ROC curves, TAPSE emerged a significant and moderate predictor for 90-day (area under curve (AUC) = 0.69, 95% CI = 0.565-0.814) and in-ICU mortality (AUC = 0.762, 95% CI = 0.652-0.871). The optimal cut-off for TAPSE was 2.1 cm for both 90-day mortality (sensitivity of 80% and specificity and 58%) and in-ICU mortality (sensitivity of 69% and specificity of 77%).

CONCLUSION

TAPSE was associated with increased mortality in those with sepsis and suspicion of cardiac dysfunction. This is a hypothesis generating paper that an association may be present and requires significant more work with expansion to the entire population base. This article is protected by copyright. All rights reserved.

Authors+Show Affiliations

Department of Critical Care Medicine, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Intensive Care Unit department, Peking University Cancer Hospital & Institute, 52 Fu-Cheng Road, Hai-Dian District, Beijing, 100142, China.Department of Critical Care Medicine, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA.Department of Critical Care Medicine, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA. Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Blvd 99, 8200, Aarhus N, Denmark.Department of Cardiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA.Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA.Department of Critical Care Medicine, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA.Department of Critical Care Medicine, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit #112, Houston, Texas, 77030, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618101

Citation

Dong, Jun, et al. "Tricuspid Annular Plane Systolic Excursion Is a Predictor of Mortality for Septic Shock." Internal Medicine Journal, 2020.
Dong J, White S, Nielsen K, et al. Tricuspid Annular Plane Systolic Excursion is a Predictor of Mortality for Septic Shock. Intern Med J. 2020.
Dong, J., White, S., Nielsen, K., Banchs, J., Wang, J., Botz, G. H., & Nates, J. L. (2020). Tricuspid Annular Plane Systolic Excursion is a Predictor of Mortality for Septic Shock. Internal Medicine Journal. https://doi.org/10.1111/imj.14957
Dong J, et al. Tricuspid Annular Plane Systolic Excursion Is a Predictor of Mortality for Septic Shock. Intern Med J. 2020 Jul 2; PubMed PMID: 32618101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tricuspid Annular Plane Systolic Excursion is a Predictor of Mortality for Septic Shock. AU - Dong,Jun, AU - White,Seth, AU - Nielsen,Kirsten, AU - Banchs,Jose, AU - Wang,Jian, AU - Botz,Gregory H, AU - Nates,Joseph L, Y1 - 2020/07/02/ PY - 2019/12/05/received PY - 2020/06/11/revised PY - 2020/06/12/accepted PY - 2020/7/4/entrez KW - Cardiac function KW - Echocardiography KW - Septic shock KW - Tissue Doppler Imaging (TDI) KW - Tricuspid Annular Plane Systolic Excursion (TAPSE) JF - Internal medicine journal JO - Intern Med J N2 - OBJECTIVE: Cardiac dysfunction is a common sequela in patients with sepsis and multi-organ dysfunction. Echocardiography is commonly used in the investigation of circulatory failure. We aimed to evaluate the prognostic value of echocardiographic parameters in patients with septic shock. METHODS: This study was a retrospective trial. We included patients who were admitted to ICU with septic shock. The patients' echocardiograms, clinical data, and outcomes were obtained from their medical records. Associations between echo-cardiogram variables and mortality were assessed using logistic regression, controlled for age, sex, BMI, and the interval between the ICU admission and echocardiogram. The utility of statistically significant echocardiogram variables to predict mortality were assessed using receiver operating characteristic (ROC) curves. RESULTS: The outcomes presented that Tricuspid Annular Plane Systolic Excursion(TAPSE) was statistically significantly associated with both ICU (p = 0.02) and 90-day (p = 0.001) mortality. From the ROC curves, TAPSE emerged a significant and moderate predictor for 90-day (area under curve (AUC) = 0.69, 95% CI = 0.565-0.814) and in-ICU mortality (AUC = 0.762, 95% CI = 0.652-0.871). The optimal cut-off for TAPSE was 2.1 cm for both 90-day mortality (sensitivity of 80% and specificity and 58%) and in-ICU mortality (sensitivity of 69% and specificity of 77%). CONCLUSION: TAPSE was associated with increased mortality in those with sepsis and suspicion of cardiac dysfunction. This is a hypothesis generating paper that an association may be present and requires significant more work with expansion to the entire population base. This article is protected by copyright. All rights reserved. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/32618101/Tricuspid_Annular_Plane_Systolic_Excursion_is_a_Predictor_of_Mortality_for_Septic_Shock L2 - https://doi.org/10.1111/imj.14957 DB - PRIME DP - Unbound Medicine ER -
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