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28.05.2018 | Original

Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database

verfasst von: Mengling Feng, Jakob I. McSparron, Dang Trung Kien, David J. Stone, David H. Roberts, Richard M. Schwartzstein, Antoine Vieillard-Baron, Leo Anthony Celi

Erschienen in: Intensive Care Medicine | Ausgabe 6/2018

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Abstract

Purpose

While the use of transthoracic echocardiography (TTE) in the ICU is rapidly expanding, the contribution of TTE to altering patient outcomes among ICU patients with sepsis has not been examined. This study was designed to examine the association of TTE with 28-day mortality specifically in that population.

Methods and results

The MIMIC-III database was employed to identify patients with sepsis who had and had not received TTE. The statistical approaches utilized included multivariate regression, propensity score analysis, doubly robust estimation, the gradient boosted model, and an inverse probability-weighting model to ensure the robustness of our findings. Significant benefit in terms of 28-day mortality was observed among the TTE patients compared to the control (no TTE) group (odds ratio = 0.78, 95% CI 0.68–0.90, p < 0.001). The amount of fluid administered (2.5 vs. 2.1 L on day 1, p < 0.001), use of dobutamine (2% vs. 1%, p = 0.007), and the maximum dose of norepinephrine (1.4 vs. 1 mg/min, p = 0.001) were significantly higher for the TTE patients. Importantly, the TTE patients were weaned off vasopressors more quickly than those in the no TTE group (vasopressor-free days on day 28 of 21 vs. 19, p = 0.004).

Conclusion

In a general population of critically ill patients with sepsis, use of TTE is associated with an improvement in 28-day mortality.

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Titel: Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database
verfasst von: Mengling Feng
Jakob I. McSparron
Dang Trung Kien
David J. Stone
David H. Roberts
Richard M. Schwartzstein
Antoine Vieillard-Baron
Leo Anthony Celi
Publikationsdatum: 28.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 6/2018
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5208-7

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Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database