Right ventricular dysfunction in critically ill patients; TAPSE and RV-TDs as applicable accurate predictors of right ventricular dysfunction: a prospective study in Egypt

Purpose To assess the impact of RV dysfunction on hospital stay and mortality and to assess the accuracy of different echocardiographic parameters of RV dysfunction. Methods A prospective study was conducted at Critical Care Unit of Assiut University Hospital. Echocardiography was performed within the first 48 h of admission and repeated on the 5–7 days of admission. Results The study enrolled 200 critically ill patients. A total of 50 (25%) patients developed RV dysfunction (RVD group). RVD group had significantly higher mean age (67.98 ± 10.56 vs. 51.75 ± 7.89 (years); p < 0.001) and the majority of patients were males. The most frequent cause of admission in patients with RVD was septic shock (38%). At “cutoff” point < 17 mm, TAPSE had the best diagnostic accuracy (91.8%) for predicting RVD in critically ill patients followed by right ventricle tissue Doppler (RV-TDs) which had 87.8% accuracy at cutoff point < 9.50 cm/s. RV-fractional area change had the least accuracy (66.3%) at cut off point < 35%, which was not statistically significant ( p = 0.19). Patients with RVD had significantly longer hospital stay (19.33 ± 3.49 vs. 12.44 ± 4.09 (days); p < 0.001) and higher frequency of mortality (30% vs. 14%). The predictors of mortality among the studied patients were RVD, low serum albumin, need to mechanical ventilation, APACHE-IV and SOFA scores. Conclusion Patients with right ventricle dysfunction during their admission have longer length of stay and higher frequency of mortality. TAPSE and RV-TDs were the most accurate echocardiographic findings for RVD.