| Objective:One of the main complications of sepsis is septic cardiomyopathy(SCM),recently,there are few research data on septic cardiomyopathy.In this study,data of sepsis patients were collected to compare the clinical characteristics of septic cardiomyopathy and non-septic cardiomyopathy,as well as survival and death of septic cardiomyopathy patients.The patients were grouped by infection sites to analyze the clinical characteristics of septic cardiomyopathy at different infection sites and determine independent risk factors.Methods:Patients diagnosed with "sepsis or septic shock" who were admitted to comprehensive Intensive care unit in the First Affiliated Hospital of Gannan Medical University from January2020 to June 2022 were selected as the research objects,and relevant clinical data were collected retrospectively.According to the survival status of 28 d sepsis patients,they were divided into survival group and death group;according to the diagnosis of septic cardiomyopathy,they were divided into septic cardiomyopathy group and non-septic cardiomyopathy group;according to the 28 d survival status of septic cardiomyopathy patients,they were divided into survival group and death group.Sepsis patients were divided into pulmonary infection group,abdominal infection group,urinary tract infection group,skin and soft tissue infection group according to the infection site.Clinical characteristics of each group were compared,and univariate and multivariate Logistic regression analysis was performed to determine independent risk factors.Results:1.In this study,318 patients with sepsis were included,with a 28 d fatality rate of 55.3%,a sepsis cardiomyopathy incidence rate of 45.9%,and a sepsis cardiomyopathy 28 d fatality rate of 57.5%.Lung infection accounted for 42.5% of septic cardiomyopathy,and abdominal infection accounted for 38.4%.2.Compared with the survival group,there were differences in age,APACHE II score,infection site,inhaled oxygen concentration,heart rate,mean arterial pressure,oxygen saturation,24 h urine volume,mechanical ventilation and other indicators in the sepsis death group(P< 0.05).3.The 28 d fatality rate of septic cardiomyopathy was 57.5% higher than that of non-septic cardiomyopathy(53.5%),and there were statistical differences in gender,24 h urine volume,PH,Pa CO2,Lac,CL-,ALT,AST,TBIL,DBIL,Cr,CK-MB,DD,WBC and other factors(P < 0.05).Univariate and multivariate logistic regression analysis showed that CL-,ALT,NT-pro BNP,Mb and the use of norepinephrine were independent risk factors for septic cardiomyopathy.4.Compared with the survival group,there were statistical differences in age,APACHE II score,infection site,oxygen concentration,oxygen saturation,24 h urine volume,mechanical ventilation and other factors(P < 0.05).Univariate and multivariate logistic regression analysis showed that: Age,site of infection,mechanical ventilation,blood potassium,and hydrocortisone use were independent risk factors for prognosis of septic cardiomyopathy.5.Compared with patients with pulmonary infection septic cardiomyopathy,there were statistical differences in body temperature,heart rate,PH,Pa CO2,Lac,CL-,AST,Cr,CK-MB,DD,NT-pro BNP,PCT and Mb(P< 0.05).Binary logistic regression analysis showed that PH,CL-,DD and NT-pro BNP were independent risk factors for pulmonary infective septic cardiomyopathy,and NT-pro BNP(AUC=0.777)had good predictive value.6.Compared with patients with abdominal septic cardiomyopathy and non-septic cardiomyopathy,there were statistical differences in death,ALT,AST,TBIL,DBIL,Cr,CK-MB,NT-pro BNP,PCT,Mb,norepinephrine and other factors at 28d(P < 0.05).Univariate and multivariate logistic regression analysis showed that Mb was an independent risk factor for the incidence of septic cardiomyopathy,and Mb(AUC=0.714)had a good predictive value.Conclusion:Sepsis has a high mortality rate,as one of the complications,the incidence of septic cardiomyopathy is also very high,and its mortality rate is even higher than that of other sepsis patients.The independent risk factors for septic cardiomyopathy were CL-,ALT,NT-pro BNP,Mb and the use of norepinephrine.The independent risk factors for the prognosis of septic cardiomyopathy were age,site of infection,mechanical ventilation,blood potassium,the use of hydrocortisone,The independent risk factors of pulmonary infection septic cardiomyopathy were PH,CL-,DD and NT-pro BNP,and the independent risk factors of abdominal infection septic cardiomyopathy were Mb. |
