nfluence of Mitral Regurgitation on the Prognosis of Patients with Septic Shock

  Objective  The aim of this study was to investigate the prognostic value of mitral regurgitation for patients with septic shock in the department of critical care medicine.

  Methods  General clinical information and cardiac valves function of patients with septic shock from April to August 2016 in the Department of Critical Care Medicine, West China Hospital of Sichuan University were collected and analyzed retrospectively from the database of SHOCK-ICU(NCT03082326). All the patients were divided into the survival group and the death group based on whether they died in 28 days after enrollment. The effects of regurgitation of the mitral valve and other valves on the prognosis were compared by the Logistic regression model. The effect of mitral regurgitation on the survival of 28 days in patients with septic shock was analyzed.

  Results  Totally 111 cases met the inclusion and exclusion criteria, including 67 males and 44 females with the average age of (57.5±18.5) years. The score of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) and the 28-day mortality were 23.6±8.6 and 46.8% (52/111), respectively. The univariate analysis showed that mitral regurgitation and the lung ultrasound aeration loss score (LUSS) of the death group were higher than those of the survival group (P=0.039 and P=0.020). Mitral regurgitation and LUSS were independent risk factors for the 28-day mortality (P=0.015 and P=0.020) by Logistic multivariate analysis. The 28-day survival rate of patients with mitral regurgitation (38.2%, 13/34) was significantly lower than that of the non-mitral regurgitation group (59.7%, 46/77) (P=0.039) by the survival analysis.

  Conclusions  Mitral regurgitation is associated with a worse prognosis in patients with septic shock.