Significance of Right Ventricular Dysfunction in Predicting Short-Term Survival Among Patients With Sepsis and Septic Shock: A Prognostic Analysis.

Abstract

Objective: This study sought to evaluate the association between right ventricular (RV) dysfunction and short-term in-hospital mortality among patients with sepsis and septic shock. Methods: A prospective cohort study was conducted on adult patients admitted at Burapha University Hospital for sepsis and septic shock from October 1, 2022, through June 30, 2023, who underwent echocardiography within 72 h after admission. RV dysfunction and other echocardiographic findings were analyzed and defined using the American Society of Echocardiography criteria. The primary outcome examined in this study was 28-day in-hospital mortality. Secondary outcomes included maximal blood lactate levels, length of intensive care unit (ICU) stay, and duration of mechanical ventilation. Results: A total of 104 patients (mean age: 69.54 ± 14.88 years) were enrolled in this study. Among the included patients, 32 (30.8%) developed septic shock whereas 20 (19.2%) exhibited RV dysfunction. Cox regression analysis showed that patients with RV dysfunction had a 28-day in-hospital mortality rate 5.53 times higher than that of patients with normal RV function (95% confidence intervals: 1.98-15.42; p=0.001). Regarding the secondary outcomes, patients with RV dysfunction exhibited a significantly higher mean serum lactate level (5.72 ± 4.96 vs. 3.74 ± 3.29 mmol/L; p=0.034) and length of ICU stay (6.50 ± 2.86 vs. 2.84 ± 1.56 days; p=0.020) than did those with normal RV function. Conclusions: RV dysfunction was associated with increased short-term mortality among patients with sepsis and septic shock. Assessing RV function among these patients facilitates precise prognostication and aids in guiding treatment strategies aimed at reducing mortality. Trial Registration: ClinicalTrials.gov identifier: NCT06193109.