Association of inferior vena cava diameter in the emergency room and early mortality in septic patients

Abstract

Introduction: Sepsis is a worldwide condition that affects nearly 30 million people and causes about 6 million deaths per year. QuickSOFA (qSOFA) has limitations in identifying at-risk patients in the emergency room. There is no known association of inferior vena cava diameter measured through Point-of-Care Ultrasound (POCUS) and mortality in septic patients. Methods: We included 39 septic patients admitted to the emergency room that received a POCUS evaluation with IVC diameter measures. One attending performed all ultrasound evaluations. Patients were analyzed according to non-dilated IVC (less than 20 mm) and dilated (more than or equal to 20 mm). Results: Overall in-hospital mortality was 33%, more frequent in the dilated IVC group (66,7% vs 27,3%) without statistical significance. The dilated IVC group had non-significant more frequencies of mechanical ventilation, ICU admission and use of vasopressors. Early-mortality (defined as less than 72 hours) was more frequent in the non-dilated group (70%) vs the dilated group (0%) with a significant p-value 0.01. Conclusion: Septic patients in the emergency room with a POCUS IVC diameter less than 20 mm are more likely of early mortality within 72 hours of admission. This finding must be confirmed with prospective research and controlling confounders.

Keywords

• POCUS. Inferior vena cava. Sepsis. Mortality.