In multivariable models, HFrEF was associated with a decreased risk-adjusted odds of receiving 30 mL/kg of intravenous fluid within the first 6 hours of sepsis onset (aOR, 0.63 95% CI, 0.47-0.85 P = .002). Patients with septic shock and HFrEF were less likely to receive guideline-recommended intravenous fluid than those with septic shock without HFrEF (96 of 380 vs 699 of 1911 P < .001), but in-hospital mortality was similar (47 of 380 vs 244 of 1911 P = .83). Results Of 5278 patients with sepsis (2673 men median age, 70 years 4349 White patients median Sequential Organ Failure Assessment score, 4 ), 884 (17%) had preexisting HFrEF, and 2291 (43%) met criteria for septic shock. Secondary outcomes included in-hospital mortality, intensive care unit admission, rate of invasive mechanical ventilation, and administration of vasoactive medications. The primary outcome was the administration of 30 mL/kg of intravenous fluid within 6 hours of sepsis onset.
Main Outcomes and Measures Multivariable models were adjusted for patient factors and sepsis severity and clustered at the hospital level to generate adjusted odds ratios (aORs) and 95% CIs. Data analyses were performed from November 1, 2020, to August 8, 2022.Įxposures Preexisting heart failure with reduced ejection fraction (≤40%) measured by transthoracic echocardiogram within 1 year prior to hospitalization for sepsis. Objective To evaluate the association between preexisting HFrEF, guideline-recommended intravenous fluid resuscitation, and mortality among patients with community-acquired sepsis and septic shock.ĭesign, Setting, and Participants A cohort study was conducted of adult patients hospitalized in an integrated health care system from January 1, 2013, to December 31, 2015, with community-acquired sepsis and preexisting assessment of cardiac function. However, there are few data on fluid administration for patients with preexisting heart failure with reduced ejection fraction (HFrEF). Importance Intravenous fluid administration is recommended to improve outcomes for patients with septic shock.
Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
0 kommentar(er)
