Martínez LE, Mendoza RM, Cortés MJA, Padilla SEA

Language: Spanish
References: 16
Page: 176-183
PDF size: 310.48 Kb.

ABSTRACT

Introduction: Sepsis is a common condition found in the Intensive Care Unit (ICU) with significant costs, both economic and human. Septic cardiomyopathy is a known but poorly diagnosed phenomenon, which develops in 60% of patients and is characterized by the presence of left ventricular dilation with normal or low filling pressures and decreased ejection fraction (LVEF), It is reversible, and normalizes within seven to 10 days of onset, having a negative impact on patient survival.
Objective: To evaluate the relationship of LVEF and C-Reactive Protein as a prognosis of mortality in septic cardiomyopathy.
Material and methods: A prospective descriptive, multicenter observational study was conducted in septic patients admitted to the ICU at 24 hours and seven days after their stay. Variables such as C-reactive protein (CRP), left ventricular ejection fraction (LVEF), age and gender were analyzed. The purpose was to correlate that the decrease in LVEF and elevated levels of C-reactive protein are useful for the prognosis of septic cardiomyopathy.
Results: 76 patients were studied, a total of 53 patients were included, excluding 14 who died and 9 who were discharged before seven days. The distribution by gender was 61.3% men and 38.7% women, the average age was 48 years. It is observed that depending on the time, those patients with a LVEF at 24 hours ≥ 49.5% show greater short-term survival (seven days). There was a moderate correlation between CRP at 24 hours and LVEF at 24 hours. The values at seven days show a high correlation and finally the LVEF values show the highest correlation with the CRP values, both at seven days.
Conclusions: During the study it was observed that the average value of CRP at 24 hours is moderately significant with a specificity of 50% for mortality prognosis. An LVEF of ‹ 49.5% has a sensitivity of 89.5% and a specificity of 85.7% for seven-day mortality prognosis, with a coefficient of determination between CRP and LVEF at seven days of 57% indicating that the increase in CRP explains the decrease in LVEF at seven days.

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