Background: In recent years, attention has shifted to the role of right ventricular (RV) dysfunction in prediction of
clinical outcome among patients with septic shock. However, very few studies have correlated RV dysfunction with
survival early in the course of sepsis. In the period from September 2021 to July 2022, we included a total number of
248 patients within 24 h of their presentation with sepsis. All patients were subjected to a comprehensive echocardiographic
study to evaluate different parameters of RV function and LV systolic and diastolic functions. We aimed
primarily to study the predictive value of RV dysfunction on 30-day all-cause mortality rates and ventilator-free days.
Results: Almost half of study population (48.4%) showed evidence of RV dysfunction (in isolation or with LV dysfunction),
with 25.4% showing evidence of isolated RV dysfunction. Patients with RV dysfunction had a significantly higher
APACHE 2 (P < 0.001) score and 30-day all-cause mortality rates (P = 0.003) compared to those without RV dysfunction.
A significant association was reported between 30-d mortality and dysfunction status (P = 0.025). Those with no dysfunction
had lower mortality (14.1%) than in those with RV dysfunction only (33.3%), LV dysfunction only (20%), and
RV + LV dysfunction (31.6%). No significant difference was observed in ventilator free days according to dysfunction
status (P = 0.081). A multivariate logistic regression analysis showed that RV dysfunction was among the significant
independent predictors for 30-day mortality (OR 2.01, 95% CI 1.07–3.81, P = 0.031), controlling for the effect of age
and gender.
Conclusions: In a cohort of ICU patients with early sepsis, RV dysfunction is found to be common and predictive of
30-day mortality irrespective to the LV function. |
