Clinical Study On The Influence Of Septic-induced Myocardial Dysfunction On The Prognosis Of Sepsis

Objective : To investigate the effect of sepsis-induced myocardial dysfunction on the prognosis of patients with sepsis and to explore the related risk factors for 28-day mortality in patients with sepsis-induced myocardial dysfunction,which provide a theoretical basis for the prediction of prognosis in patients with sepsis.Methods : We retrospectively analyzed 129 patients with sepsis in the Intensive Care Unit,the First Affiliated Hospital of Guangxi Medical University from December 2014 to December 2018.The corresponding statistical methods were used to analyze the correlation between the effect of sepsis-induced myocardial dysfunction on the prognosis of patients with sepsis.COX single-factor analysis and COX multi-factor regression analysis were used to analyze the independent risk factors for 28-day mortality in patients with sepsis-induced myocardial dysfunction.Results:(1)20 patients(71.4%)died in the observation group,57 patients(56.4%)died in the control group.There was no significant difference between the two groups(P = 0.152);(2)Left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular end-diastolic volume,andserum troponin I were higher in the observation group than in the control group.The left ventricular ejection fraction of the observation group was lower than that of the control group(P < 0.05).(3)COX single-factor analysis showed that APACHE-II score(P = 0.004),SOFA score(P = 0.045),PCT(P = 0.007),CK-MB(P = 0.019),cTn T(P = 0.095)and lactic acid(P = 0.000)were significantly associated with 28-day mortality in the observation group;(4)COX multi-factor regression analysis showed that PCT(HR = 1.016,95% CI:1.003-1.030,P = 0.014)and lactic acid(HR=1.571,95% CI: 1.246-1.981,P =0.000)were independent risk factors for death in the observation group.Conclusion: In this research,patients with sepsis-induced myocardial dysfunction do not necessarily have a poor prognosis compared with patients without sepsis-induced myocardial dysfunction;PCT and lactic acid are independent risk factors for 28-day mortality in patients with sepsis-induced myocardial dysfunction.