Correlation between Sequential Organ Failure Assessment (SOFA) Score with Right Ventricular Systolic Function and Left Ventricular Filling Pressure in Sepsis Patients

Abstract

This research aimed to evaluate the relationship of sepsis severity assessed using SOFA scores with RV systolic function and LVFP. Methods: This cross-sectional observational study involved 25 dr. Kariadi General Hospitals septic patients without cardiac disease. The SOFA score as a study subject was calculated up to a maximum of 3 times per patient parallel to the RV function examination.  Echocardiographic RV function parameter we used Tricuspid Annular Plane Systolic Excursion (TAPSE), Right Ventricle Fractional Area Change (RV-FAC), Right Ventricle Free Wall Strain (RV-FWS), Right Ventricle-Pulmonary Artery (RV-PA) coupling, and LVFP using the Nagueh formula and ASE/EACVI 2016 criteria. Correlation tests were conducted between SOFA scores with TAPSE, RV-FAC, RV-FWS, RV-PA coupling, and LVFP. Results: There were 56 samples of SOFA scores and echocardiography. There was a significant correlation between SOFA scores and TAPSE (r = -0.44, p = 0.001), RV-FAC (r = -0.54, p = <0.001), RV-FWS (r = -0.52, p = <0.001), RV-PA coupling (r = -0.32, p = 0.014). No significant correlation was found between SOFA and LVFP scores with Nagueh (r = 0.11, p = 0.42) and the 2016 ASE/EACVI criteria (r= -022, p= 0.09). RV-FWS can detect RV dysfunction earlier than other parameters. Conclusion: SOFA score is associated with RV function but not with LVFP. Echocardiography in septic patients can be considered to detect early RV dysfunction.