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

Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Intensive Care Medicine Springer Journals

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

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature and ESICM
Subject
Medicine & Public Health; Intensive / Critical Care Medicine; Anesthesiology; Emergency Medicine; Pneumology/Respiratory System; Pain Medicine; Pediatrics
ISSN
0342-4642
eISSN
1432-1238
D.O.I.
10.1007/s00134-018-5208-7
Publisher site
See Article on Publisher Site

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

Journal

Intensive Care MedicineSpringer Journals

Published: May 28, 2018

References

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