The analysis on clinical characteristics and risk factors in patients with sepsis-associated pulmonary hypertension

Abstract

Objective To analyze clinical characteristics and risk factors of pulmonary hypertension (PH) in patients with sepsis. Methods According to retrospective analysis of clinical data 136 cases with sepsis were divided into PH group and non-PH group. The clinical data, laboratory findings and ultrasonic cardiographic findings were recorded and compared between two groups. Multi-factors Logistic regression analysis was performed to find the independent risk factors of PH in patients with sepsis, and receiver operating characteristic curve ROC was constructed to indicate the predictable value. Results Of 136 patients with sepsis, 32 (23.5%) developed PH. The PH group had higher NT-proBNP [lgNT-proBNP (3.67±0.41) vs. (3.33±0.59), P=0.003], higher E peak [(86.12±30.43) vs. (67.73±21.49), P=0.008], higher E/A peak [(1.09±0.46) vs. (0.83±0.29), P=0.014], higher left atrium diameter (LAD) [(36.49±5.97) vs. (31.32±4.69), P=0.001] and lower oxygenation index [(291.90±51.62) vs. (326.40±88.16), P=0.017] than the non-PH group (P < 0.05). It was shown by multi-factors Logistic regression analysis that LAD (OR=1.198, P=0.010) was an independent risk factor of PH in patients with sepsis. The area under the curve AUC of LAD was 0.723, with the cut-off value of 31 mm (sensibility =82.6%, specificity=49.0%). Conclusions LAD was an independent risk factor of sepsis-associated pulmonary hypertension in sepsis patients. Key words: Sepsis; Pulmonary hypertension; Left atrium diameter; Tricuspid regurgitation velocity; N-terminal pro brain natriuretic peptide; Oxygenation index; Early diastolic transmitral velocity; Late diastolic transmitral velocity