A prognosis analysis for septic shock combined with heart failure on admission

Wang Jian-jun; Dong Hai-shan; Wen Li-rong

doi:10.3969/j.issn.1002-1949.2018.01.007

Abstract：Objective To investigate the prognostic value for the in -hospital patients with septic shock and heart failure ( HF ) on admission.Methods The study was performed with a prospective, randomized method.24 septic shock and structural heart disease (SHD) with HF patients in EICU and ICU were included in the study group , the corresponding period , 24 septic shock patients without SHD and HF were included in the control group .Association between HF on admission and 28 days in-hospital mortality of septic shock was analyzed .Results Fluid responders in study group were significantly less than those in control group (P<0.01).6h-lactate clearance rate in study group was significantly lower than that in control group (P<0.01).The patients of using dobutamine in study group were significantly more than the patients in control group (P <0.01).The patients of using continuous renal replacement therapy ( CRRT) were significantly more than the patients in control group (P<0.05).The duration of invasive mechanical ventilation and ICU stay were significantly longer in study group than those in control group (P <0.01).Kaplan -Meier survival analysis showed that patients in study group had significant higher in -hospital 28 days mortality compared with control group (P<0.05).Multiple Cox proportional hazard analysis showed that BNP ( HR =1.002, 95％CI 1.000～1.002, P <0.05 ), LC ( HR =1.189, 95％CI 1.010 ～1.399, P <0.05 ), fluid responsiveness (HR=0.228, 95％CI 0.061～0.852, P<0 .05) remained as independent predictors of death for septic shock with HF .Conclusion BNP, LC and fluid responsiveness on admission are associated with septic shock and SHD with HF patients in -hospital 28 days mortality .