Effect of hyperdynamic left ventricular ejection fraction on prognosis of early septic shock patients

Objective To investigate the effect of hyperdynamic left ventricular ejection fraction (HDLVEF) on prognosis of patients with early septic shock.

Methods A total of 96 patients with septic shock admitted to Northern Jiangsu People's Hospital were selected as study objects. Patients were divided into death group (n=40) and survival group (n=56) according to whether patients died within 28 days or not. Independent sample t test or Chi-square test were used to analyze whether there were significant differences in clinical data between the two groups. Influencing factors for occurrence of death in patients with septic shock were assessed by binary Logistic regression model. The correlations of HDLVEF with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure estimation (SOFA) score were evaluated by Pearson and Spearman correlation analysis. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of indicators for death in patients with septic shock. Kaplan-Meier curve was used to analyze the prognostic survival of patients with septic shock.

Results The differential pressure of central venous arterial carbon dioxidep_cv-a(CO₂), APACHE Ⅱ score, SOFA score and HDLVEF in the death group were higher than those in the survival group (P < 0.05). Binary Logistic regression analysis showed that HDLVEF, p_cv-a(CO₂) and SOFA score were infuencing factors for death in septic shock patients (P < 0.05). Pearson and Spearman correlation analysis showed that HDLVEF was positively correlated with SOFA score and APACHE Ⅱ score (P < 0.05). ROC curve showed that the area under the curve (AUC) of HDLVEF was higher than that of p_cv-a(CO₂) or SOFA. AUC of HDLVEF combined with SOFA score and p_cv-a(CO₂) was significantly higher than those of single indexHDLVEF, SOFA score or p_cv-a(CO₂), and the sensitivity and specificity were 87.50% and 83.93%, respectively. Kaplan-Meier curve showed that the 28-day survival rate in patients with septic shock was lower in high HDLVEF level patients than those with low HDLVEF level(P < 0.05).

Conclusion The level of HDLVEF is an important factor affecting the death of patients with septic shock, and it can reflect the patient's condition and predict the death of patients, which is expected to become an effective clinical indicator.