Key result
Higher echocardiography score at ICU admission linked to ~56% lower 28-day mortality.
Why the study?
Echocardiography is widely used for bedside monitoring in the ICU, but the characteristics of echocardiographic manifestations across patient groups and their association with outcomes needed to be described.
Cohort (n=1,682)
Yes
Odds Ratio: 0.443 (95% CI 0.228–0.861)
p-value: p=0.016
Echocardiography score and specific echocardiographic abnormalities are independent risk factors for 28-day mortality in ICU patients.
Echocardiography scoring may aid early ICU risk stratification; hypothesis-generating and requires prospective validation before practice change.
Background Echocardiography is widely used for bedside monitoring in ICU. We aimed to describe the characteristics of echocardiography manifestations in different groups of ICU patients, and the association with the outcomes.Methods This is a prospective multiple-center cohort study took place in 17 ICUs in China. A total of 1682 continuous adult patients admitted between August 31, 2017 to February 16, 2019 who had echocardiography performed within 24 hours in ICU were included. The echocardiography was performed and the echocardiography scores were calculated. Data was analyzed and compared between different outcome and primary indication groups.Results The overall 28-day mortality was 15.76%. Left ventricle enlargement and other echocardiogram abnormalities were more common in the non-survivors than the survivors. The EF value was lower, and the decrease in EF value was more frequent in the non-survivors than the survivors. The echocardiography score was significantly higher in the non-survivors than the survivors. The incidence of right ventricle enlargement and EF decrease was high in ICU patients (26.52% and 26.93% respectively). The independent risk factors for 28-day mortality was APACHE II, the length of MV, the length of ICU stay, oxygenation index, right ventricle wall thickening, IVC diameter, IVC variability, and the echocardiography score.Conclusions The incidence of cardiac dysfunction is high in ICU patients. The echocardiography score was significantly higher in the non-survivors than the survivors, and was an independent risk factor for 28-day mortality. Echocardiography is a convenient bedside monitoring method which deserves widely use in ICUs.Trial registration: Chinese Clinical Trial Registry (ChiCTR-DDD-17012391). Registered 2017.08.17. http://www.chictr.org.cn/showprojen.aspx?proj=21127.
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Peng et al. (2020) conducted a cohort in Critical illness requiring ICU admission (n=1,682). Echocardiography score was evaluated on 28-day mortality (OR 0.443, 95% CI 0.228-0.861, p=0.016). A higher echocardiography score assessed within 24 hours of ICU admission was an independent risk factor for 28-day mortality (OR 0.443).
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