Utilization of echocardiography during septic shock was associated with a decreased 28-day mortality: a propensity score-matched analysis of the MIMIC-III database
| Autor: | Ru-Shuang Yan, Ting-Ting Wang, Qian-Qian Wang, Yunsong Yu, Bu-Wen Yu, Peng Lan, Ling Lin, Jiancang Zhou, Wei-Chao Liao, Kong-Han Pan, Hang-Yang Li |
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| Rok vydání: | 2019 |
| Předmět: |
Cardiac function curve
Inotrope Cardiac output Database Septic shock business.industry medicine.medical_treatment Pulmonary artery catheter 030208 emergency & critical care medicine General Medicine computer.software_genre medicine.disease 03 medical and health sciences 0302 clinical medicine Intensive care Propensity score matching medicine Intravascular volume status 030212 general & internal medicine business computer |
| Zdroj: | Annals of Translational Medicine. 7:662-662 |
| ISSN: | 2305-5847 2305-5839 |
| DOI: | 10.21037/atm.2019.10.79 |
| Popis: | Background: Hemodynamic management is of paramount importance in patients with septic shock. Echocardiography has been increasingly used in assessing volume status and cardiac function. However, whether the utilization of echocardiography has an impact on prognosis is unknown. Thus, we intended to explore its effect on the outcomes of patients with septic shock. Methods: The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. Septic shock patients were divided into two groups according to the usage of echocardiography during the onset of septic shock. The primary outcome was 28-day mortality. Secondary outcomes included the usage of inotropes, ventilation-free and norepinephrine-free time, and fluids input. Propensity-score matching was used to reduce the imbalance. Results: Among 3,291 eligible patients, 1,289 patients who underwent echocardiography (Echo), and 1,289 who did not receive the Echo, had similar propensity scores and were included in the analyses. After matching, the Echo group had a significantly lower 28-day mortality (33.2% vs . 37.7%, P=0.019). More patients in the Echo group received pulmonary artery catheter (PAC) (4.2% vs . 0.2%, P vs . 7.1%, P vs . those without Echo was maintained either when excluding patients receiving multiple echocardiography scans (HR, 0.82; 95% CI, 0.72–0.94; P=0.004) or when excluding patients undergoing PAC or pulse index continuous cardiac output (PiCCO) (HR, 0.87; 95% CI, 0.76–0.99; P=0.034). Conclusions: Utilization of echocardiography was associated with improved 28-day outcomes in patients with septic shock. |
| Databáze: | OpenAIRE |
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