1177: PREVALENCE AND PROGNOSIS OF SEPSIS-INDUCED CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Introduction: Sepsis is a critical systemic inflammatory syndrome caused by infection, leading to various organ failures. Sepsis-induced cardiomyopathy (SICM), which can be defined as new-onset left ventricular (LV) systolic dysfunction, is one of such sepsis-induced organ failures. Although previous meta-analyses suggested that LV systolic dysfunction defined by reduced LV ejection fraction in patients with sepsis was not associated with higher or lower mortality, studies included in these meta-analyses did not exclude patients with underlying myocardial diseases. Hence, the prevalence and prognosis of the new-onset LV dysfunction during sepsis remains unknown. Therefore, we conducted a systematic review and meta-analysis on the prevalence and prognosis of SICM. Methods: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and Embase. Inclusion criteria were as follows: (1), randomized controlled, cohort, or cross-sectional study, (2) adult patients (≥ 18 years) with sepsis, and (3) investigated the prevalence of SICM or compared short-term mortality between patients with and without SICM. Hereby, we defined SICM as a new-onset reduced LVEF during sepsis. We presented the results of all analyses with the use of random-effects models. The primary outcome was the prevalence of SICM and its impact on short-term mortality. P-value < 0.05 was considered statistically significant. Results: Thirty studies including 7,920 patients were included in the final meta-analysis. The sample size ranged from 35 to 3,530. All studies reported the prevalence of SICM in patients with sepsis and the pooled prevalence of SICM was 28% [95% confidence interval (CI), 23 to 34%]. Seventeen studies reported short-term mortality. The pooled odds ratio of short-term mortality associated with the presence of SICM was 1.88 (95% CI, 1.40–2.52; P< 0.001). Conclusions: In the meta-analysis, SICM was common in patients with sepsis, and it was associated with higher short-term mortality. This study suggests the importance of further investigation of personalized treatment in patients with SICM.