The following is a summary of “Sepsis-Induced Cardiomyopathy Detected With Focused Cardiac Ultrasound in the Emergency Department” published in the October 2022 issue of Emergency Medicine by Tucker et al.
The multi-organ failure seen in sepsis increases the likelihood of death. Heart failure caused by sepsis is called sepsis-induced cardiomyopathy (SIC). As such, researchers set out to see if focused cardiac ultrasonography may be utilized to diagnose SIC in the emergency department (ED), focused cardiac ultrasound (FCU). Adults with sepsis who presented to 1 ED during a period of 21 months were studied retrospectively.
For inclusion, patients needed to meet clinical sepsis criteria, have baseline echocardiography conducted within the past 12 months, and have received an FCU from an emergency physician in the ED. As determined by FCU, the incidence of SIC was defined as a significant drop from baseline in left ventricular ejection fraction (LVEF). Patients with normal baseline LVEF and no reduction in the presentation were compared with patients with decreased LVEF and no significant change, and patients with a significant drop in LVEF from normal baseline were compared with patients with a normal baseline LVEF (SIC).
Among the 110 patients who met inclusion criteria, 89 were classified as having normal LVEF (81%), 12 as having previously decreased LVEF (11%), and 9 as having SIC (8%). Patients with SIC (67%) and preexisting reduced LVEF (58%) had a significantly greater unadjusted 90-day mortality than those with normal EF (29%; P=0.019). SIC was linked with mortality at 90 days (odds ratio 6.1, 95% confidence range 1.37-32.92) after controlling for age, gender, Charlson Index score, and lactate more than 4.0 mmol/L. Physicians in the ED can use FCU to diagnose SIC, which is linked to a higher risk of death within 90 days.