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Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock

ACTA MEDICA INDONESIANA · Vol. 51 No. 1 (2019)

ISSN
2338-2732, 0125-9326
Terbit
2019-05-10
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pathophysiology of cardiovascular disorder in patients with septic shock. This study aimed to evaluate the roles of echocardiography, cardiovascular biomarkers, venous oxygen saturation and renal function as predictors of mortality rate in patients with septic shock. Methods: this is a prospective cohort study in patients with infections, hypotension (MAP 2 mmol/L. On the first and fifth days, septic patients underwent echocardiography and blood tests. Statistical analysis used in our study included t-test or Mann-Whitney test for numeric data and chi-square test for nominal data of two-variable groups; while for multivariate analysis, we used Cox Regression model. Results: on 10 days of observation, we found 64 (58%) patients died and 47 (42%) patients survived. The mean age of patients was 48 (SD 18) years. Patients with abnormal left ventricular ejection fraction (LVEF) had 1.6 times greater risk of mortality than those with normal LVEF (RR 1.6; p = 0.034). Patients with abnormal troponin I level showed higher risk of mortality as many as 1.6 times (RR: 1.6; p = 0.004). Patients with impaired renal function had 1.5 times risk of mortality (RR 1.5; p = 0.024). Patients with abnormal troponin I level and/or impaired renal function showed increased mortality risk; however, those with normal troponin I level and impaired renal function also showed increased mortality risk. Multivariate analysis revealed that left ventricular ejection fraction and troponin I level may serve as predictors of mortality in patients with septic shock. (HR 1.99; 95% CI: 1.099 ̶ 3.956; p = 0.047 and HR: 1.83; 95%CI: 1.049 ̶ 3,215; p = 0.043). Conclusion: left ventricular ejection fraction and biomarkers such as troponin I level are predictors of mortality in septic shock patients.

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  • Universitas Islam Batik
  • Sebelas Maret University
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Rekan penulisOrganisasiArtikel bersama
Andhika RachmanAfiliasi tidak diketahui3
Cleopas M RumendeAfiliasi tidak diketahui3
Sally Aman NasutionAfiliasi tidak diketahui3
Karmel L TambunanAfiliasi tidak diketahui2
Ikhwan RinaldiAfiliasi tidak diketahui2
Idrus AlwiAfiliasi tidak diketahui2
Evy YunihastutiAfiliasi tidak diketahui2
Simon SalimAfiliasi tidak diketahui2
Nurul Inayah RahmaniAfiliasi tidak diketahui2
Suroto SurotoSebelas Maret University2
Muchtaruddin MansyurAfiliasi tidak diketahui2
Al RasyidAfiliasi tidak diketahui2
Jusuf MisbachAfiliasi tidak diketahui2
Jan S PurbaAfiliasi tidak diketahui2
Efta YudiarsahAfiliasi tidak diketahui2
Ceva W PitoyoAfiliasi tidak diketahui2
Adityo SusiloAfiliasi tidak diketahui2
Tri Kusno Widi AsmoroUniversitas Islam Batik1
Anita WijayantiUniversitas Islam Batik1
Yulia Yusrini DjabirAfiliasi tidak diketahui1
Mirnawati SalampeAfiliasi tidak diketahui1
Andri Maruli T LubisAfiliasi tidak diketahui1
Kurniadi HusodoAfiliasi tidak diketahui1
Djajadiman GatotAfiliasi tidak diketahui1
Arini SetiawatiAfiliasi tidak diketahui1
T. Djumhana AtmakusumaAfiliasi tidak diketahui1
Shufrie EffendiAfiliasi tidak diketahui1
Augustine PurnomowatiAfiliasi tidak diketahui1
Sri Hartini KS KariadiAfiliasi tidak diketahui1
Tri H AchmadAfiliasi tidak diketahui1
Johanes C MoseAfiliasi tidak diketahui1
Nadia A MulansariAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Cardiac Performance by Echocardiography, Cardiovascular Biomarker, Kidney Function, and Venous Oxygen Saturation as Mortality Predictors of Septic Shock</dc:title>
	<dc:creator>Rahasto, Pudjo</dc:creator>
	<dc:creator>Setianto, BUdhi</dc:creator>
	<dc:creator>Timan, Ina S</dc:creator>
	<dc:creator>Suhendro, Suhendro</dc:creator>
	<dc:creator>Sukrisman, Lugyanti</dc:creator>
	<dc:creator>Sukamawan, Renan</dc:creator>
	<dc:creator>Sudaryo, Mondastri K</dc:creator>
	<dc:creator>Kabo, Peter</dc:creator>
	<dc:subject xml:lang="en-US">echocardiography</dc:subject>
	<dc:subject xml:lang="en-US">death</dc:subject>
	<dc:subject xml:lang="en-US">NT Pro BNP</dc:subject>
	<dc:subject xml:lang="en-US">septic shock</dc:subject>
	<dc:subject xml:lang="en-US">troponin I</dc:subject>
	<dc:description xml:lang="en-US">Background: cardiac function in patients with septic shock at the cellular level can be assessed by measuring troponin I and NT Pro BNP levels. Venous oxygen saturation is measured to evaluate oxygen delivery and uptake by organ tissue. Our study may provide greater knowledge and understanding on pathophysiology of cardiovascular disorder in patients with septic shock. This study aimed to evaluate the roles of echocardiography, cardiovascular biomarkers, venous oxygen saturation and renal function as predictors of mortality rate in patients with septic shock. Methods: this is a prospective cohort study in patients with infections, hypotension (MAP &amp;lt; 65 mmHg) and serum lactate level of &amp;gt; 2 mmol/L. On the first and fifth days, septic patients underwent echocardiography and blood tests. Statistical analysis used in our study included t-test or Mann-Whitney test for numeric data and chi-square test for nominal data of two-variable groups; while for multivariate analysis, we used Cox Regression model. Results: on 10 days of observation, we found 64 (58%) patients died and 47 (42%) patients survived. The mean age of patients was 48 (SD 18) years. Patients with abnormal left ventricular ejection fraction (LVEF) had 1.6 times greater risk of mortality than those with normal LVEF (RR 1.6; p = 0.034). Patients with abnormal troponin I level showed higher risk of mortality as many as 1.6 times (RR: 1.6; p = 0.004). Patients with impaired renal function had 1.5 times risk of mortality (RR 1.5; p = 0.024). Patients with abnormal troponin I level and/or impaired renal function showed increased mortality risk; however, those with normal troponin I level and impaired renal function also showed increased mortality risk. Multivariate analysis revealed that left ventricular ejection fraction and troponin I level may serve as predictors of mortality in patients with septic shock. (HR 1.99; 95% CI: 1.099  ̶  3.956 ; p = 0.047 and HR: 1.83 ; 95%CI: 1.049  ̶ 3,215 ; p = 0.043). Conclusion: left ventricular ejection fraction and biomarkers such as troponin I level are predictors of mortality in septic shock patients.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2019-05-10</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/518</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 51 No. 1 (2019): Acta Medica Indonesiana; 47</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/518/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2019 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>