The Predictive Value of Echocardiography for Evaluation of Sepsis-Induced Cardiac Dysfunction and Mortality Outcomes in Critically-ill Septic Patients in Comparison with APACHE II and qSOFA Clinical Scores

Mostafa, Mostafa Mohamed Abdelhakeam; Al-Habbaa, Ahmed Mohammed Salah El-Din Ahmed; Elfar, Badr Esmail Fadlallah; Abo.Shapaik, Ismail Abd.Ellatif

doi:10.21608/aimj.2025.446550

The Predictive Value of Echocardiography for Evaluation of Sepsis-Induced Cardiac Dysfunction and Mortality Outcomes in Critically-ill Septic Patients in Comparison with APACHE II and qSOFA Clinical Scores

Document Type : Original Article

Authors

¹ Anesthesia, Intensive Care and Pain Management, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Cardiology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446550

Abstract

Background: Sepsis remains a major global health issue, characterized by a systemic inflammatory response to infection that leads to widespread organ dysfunction.
Aim of the work: This work aimed to evaluate the prognostic value of echocardiography in predicting sepsis-induced cardiac dysfunction (SICD) and compare its effectiveness with clinical scoring systems like APACHE II and qSOFA.
Methods: In the intensive care unit (ICU) of Al-Azhar University Hospitals, 90 patients with sepsis were included in this prospective observational cohort study. This study'sstudy's primary focus was the evaluation of echocardiographic parameters. In addition, evaluation of Clinical scores such as APACHE II and qSOFA.
Results: The presence of diabetes mellitus (DM) and hypertension (HTN) significantly increased the risk of mortality (P>0.05). Higher serum lactate level is a well-established marker of sepsis severity and mortality. Cardiomyopathy was significantly associated with higher mortality (P>0.05). LVEF at day 3 (LVEF_3) and LVEF at day 7 (LVEF_7) were significant predictors of mortality. APACHE II Score was a significant indicator of mortality (P>0.05). The combined analysis of the APACHE II score and LVEF at day 3 (LVEF_3) was a strong independent predictor (94.8%) of the variability in mortality among critically ill septic patients.
Conclusions: Lower LVEF values at different time points (initial, day 3, and day 7) are linked to higher mortality rates. Echocardiography provides additional prognostic value compared to traditional clinical scores like APACHE II and qSOFA. Older patients with comorbidities like diabetes and hypertension have worse outcomes.

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