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Indian Journal of Emergency Medicine

Volume  5, Issue 3, July-September 2019, Pages 153-163
 

Original Article

To Determine Cardiac Function As A Predictor of Outcome in Patients with Septic Shock

Banna Divya1, B Phanikrishna2, K Raghu3, GD Ravindranath4

1Post Graduate, 2Professor, 3Associate Professor, 4Associate Professor, Department of Pediatrics, Narayana Medical College and Hospital, Chintareddypalem, Nellore, Andhra Pradesh 524003, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.5319.1

Abstract

Aim: Aim of the present study is to study the significance of echocardiography in patients with septic shock along with the significance of clinical prediction scores and their correlation with echocardiography findings in prognosis of a population of 50 septic shock patients presenting to ED in a tertiary care hospital. Method: The present study is conducted on 50 patients with septic shock presented to Department of Emergency Medicine, during July 2016 to November 2018. Results: The most common comorbid condition in the study was Type II Diabetes Mellitus. The most common diagnosis in the present study is Urosepsis with a contribution of 24% patients and mortality of 50%. In present study, 46% had normal LV function, 28% had Mild LV dysfunction, 22% had moderate LV dysfunction and 4% had severe LV dysfunction. The mean APACHE II in patients with No LVD is 14.957, mild LVD is 17.929, moderate LVD is 21.818 and severe LVD is 24. The mean qSOFA in patients with No LVD is 2.04, mild LVD is 2.43, moderate LVD is 2.36 and severe LVD is 2.50. The mean IVC diameter in patients with No LVD is 1.25 cm, Mild LVD is 1.68 cm, moderate LVD is 2.08 cm and severe LVD is 2.25 cm. Mortality in patients with APACHE II score >20 is 94.1%, i.e. 16 patients. Mortality in patients with qSOFA score 3 is 92.3%. APACHE II had positive correlation with qSOFA and negative correlation with LVEF and LOHS. Outcome of the present study showed 52% survivors and 48% non-survivors. Transthoracic echocardiography in ED has significant correlation with clinical prediction scores (APACHE II and qSOFA scores). Conclusion: the prognostic power of the qSOFA score at ICU admission regarding patients with septicemia. Present study results show that the qSOFA score ≥2 in admission could be helpful as a screening device for predicting clinical intensity and medical resource make use of within 72 hours right after admission, and for forecasting the 28-day mortality price.

Keywords: Septic Shock; Glasgow Coma Scale; Left Ventricular ejection fraction; Nitric oxide


Corresponding Author : Kondle Raghu