A simplified definition of diastolic function in sepsis, compared against standard definitions.

ABSTRACT: Background:Guidelines for grading diastolic dysfunction poorly categorize septic patients. We compared how well the American Society of Echocardiography (ASE) 2009 and 2016 definitions and a simplified definition categorized septic patients. Methods:We studied septic patients who received a transthoracic echocardiogram within 24?h of admission to an ICU. We categorized patients according to ASE 2009 and 2016 definitions and a definition using E/e', a surrogate for left ventricular filling pressure. We assessed 28-day all-cause mortality and the presence of pre-existing diabetes, hypertension, or myocardial infarction. We tested for associations among diastolic grade, comorbidities, and outcomes using logistic regression. Results:We studied 398 patients. Mortality was 23%. The simplified definition categorized more patients than ASE 2016 (78% vs. 71%, p =?0.035); both definitions categorized more patients than ASE 2009 (34%, p ?9 and 7% had a severely abnormal E/e' >?13. Conclusions:The ASE 2016 definition categorizes more septic patients than the ASE 2009 definition, but it does not categorize the diastolic function of a third of septic patients. ASE 2016 designates many patients with elevated E/e' as normal. A simplified definition categorized patients with less ambiguity and is associated with relevant comorbidities.

SUBMITTER: Lanspa MJ 

PROVIDER: S-EPMC6381727 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature