Evaluation of the splenic Doppler resistive index as a hemodynamic variable and its association with mortality in sepsis: A prospective cohort study

脾脏多普勒阻力指数作为血流动力学变量的评估及其与脓毒症死亡率的关系:一项前瞻性队列研究

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Abstract

This study aims to estimate the association between the splenic Doppler resistive index (SDRI) and in-hospital mortality in patients with sepsis. A prospective analytic cohort study was conducted on 109 consecutive adult patients with sepsis or septic shock, admitted to the emergency resuscitation room of a 4th-level referral center in Bogotá, Colombia, between November 2023 and October 2024, until the required statistical sample size was reached. A total of 109 consecutive adult patients (aged ≥18 years) with a diagnosis of sepsis or septic shock, based on the Sepsis-3 definition, were admitted to the emergency resuscitation room. Exclusion criteria included pregnancy, breastfeeding, inability to perform an apnea maneuver for Doppler measurement, severe hyperactive delirium, abdominal conditions limiting ultrasound access, severe peripheral arterial disease, disorders affecting hepatosplanchnic circulation, and permanent cardiac arrhythmias. The SDRI was measured within the 1st 6 hours after admission to the emergency resuscitation unit. The principal investigator received standardized training from the affiliated radiologist. Additional clinical variables were simultaneously recorded using a standardized data collection tool, including demographic characteristics, vital signs, site of infection, laboratory tests, blood culture, capillary refill time, Glasgow Coma Scale, and mottling score. In sepsis, SDRI of >0.7 showed lower survival from day 0 to day 38 of hospitalization. Thus, an association between SDRI of >0.7 and in-hospital mortality is suggested. Further studies are required to confirm these findings.

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