Supplemental table 1. Blood test results of intensive care unit (ICU) septic shock patients

ICU mortality / Hospital mortality
Death
(n=35) / Survival
(n=76) / pé / Death
(n= 39) / Survival
(n=72) / pé
Hemoglobin (g/dL) / 10.5±3.1 / 11.2±2.6 / 0.22 / 10.4±3.0 / 11.3±2.6 / 0.11
WBC (k/mL) ‡ / 15.0 (7.9, 17.3) / 12.0 (9.3, 15.9) / 0.16 / 14.6 (7.9, 16.9) / 12.1 (9.3, 16.2) / 0.38
Neutrophil (k/mL) ‡ / 14.1 (7.8, 16.5) / 12.0 (9.0, 14.7) / 0.18 / 13.9 (7.8, 15.9) / 12.0(9.0, 15.4) / 0.38
Platelet (k/mL) / 148.6±110.9 / 167.3±102.4 / 0.40 / 148.4±111.4 / 168.5±101.5 / 0.35
hsCRP (mg/L) ‡ / 54.5 (8.9, 18.1) / 59.0 (23.1, 110.0) / 0.56 / 61.0 (8.9, 184.0) / 56.6 (23.1, 99.0) / 0.78
BNP (pg/ml) / 1432.6±142.4 / 1620.67±109. 2 / 0.15 / 1356.4±92.2 / 1730.0±198.7 / 0.31
Albumin (g/dL) ‡ / 2.6 (2.2, 3.0) / 2.8 (2.4, 3.0) / 0.34 / 2.7 (2.2, 3.0) / 2.8 (2.4, 3.1) / 0.23
ALT (U/L) ‡ / 45.0 (33.0, 63.0) / 40.0 (25.0, 69.0) / 0.45 / 50.0 (33.0, 64.5) / 38.0 (21.8, 69.0) / 0.24
cTnT (ng/mL) ‡ / 0.10 (0.04, 0.28) / 0.09 (0.03, 0.12) / 0.32 / 0.09 (0.03, 0.31) / 0.09 (0.03, 0.12) / 0.38
Lactate (mg/dL) ‡ / 3.7 (1.9, 5.2) / 2.8 (1.7, 3.5) / 0.24 / 3.3 (1.8, 5.2) / 2.8 (1.7, 3.5) / 0.31
Na (mg/dL) / 134.9±14.0 / 137.1±10.2 / 0.39 / 135.7±13.9 / 136.8±10.1 / 0.65
CCr (mL/min/1.73m2)‡ / 28.0 (17.6, 75.5) / 38.4 (20.3, 76.8) / 0.72 / 29.1 (20.4, 77.4) / 37.1 (20.2, 76.8) / 0.91

Abbreviations: ALT, alanine transaminase; BNP, B-type natriuretic peptide; CCr, creatinine clearance rate; cTnT, cardiac troponin T; hsCRP, high sensitivity C-reactive protein; Na, sodium; WBC, white blood cells.

Unless specified otherwise, data are expressed as mean ± SD.

é p value for comparison between patients with and without mortality by Student’s t-test for normal distributed continuous data and nonparametric test for non-normal distributed continuous data.

‡ Median (interquartile range)

Supplemental table 2. Univariable and multivariable predictors of hospital mortality.

Univaribale / Multivariable
Model 1 / Model 2
HR
(95% CI) / p / HR
(95% CI) / p / HR
(95% CI) / p
Age / 1.00
(0.98-1.02) / 0.99 / -- / -- / -- / --
Male gender / 0.66
(0.33-1.30) / 0.23 / -- / -- / -- / --
Hypertension / 0.54
(0.26-1.15) / 0.11 / -- / -- / -- / --
Alcoholism / 1.65
(0.77-3.55) / 0.20 / -- / -- / -- / --
APACHE II score
(24 hours) / 1.05
(1.02-1.09) / 0.006 / 1.06
(1.02-1.11) / 0.003 / 1.06
(1.02-1.11) / 0.006
Heart rate / 1.02
(0.99-1.20) / 0.07 / 1.02
(0.99-1.03) / 0.07 / 1.02
(0.99-1.03) / 0.07
Reduced GLS
(GLS ³-13%) / 3.55
(1.83-6.87) / < 0.001 / 3.97
(1.91-8.21) / < 0.001 / -- / --
GLS / 1.12
(1.04-1.20) / 0.002 / -- / -- / 1.12
(1.05-1.20) / 0.001

Abbreviations: APACHE, acute physiology age and chronic health evaluation; CI, confidence interval; GLS, global left ventricular peak systolic longitudinal strain; HR, hazard ratio.

Supplemental table 3. The global left ventricular peak systolic longitudinal strain (GLS) between survivors and non-survivors of the septic shock patients with preserved LVEF (≥50%) or impaired LVEF (<50%) during the period of (A) ICU admission or (B) hospitalization.

LVEF < 50% / LVEF ≥ 50%
A.  ICU period / Survival (n=4) / Death (n=7) / p / Survival (n=72) / Death (n=28) / p
GLS (%) / -11.1 ± 4.4 / -9.5 ± 3.5 / 0.54 / -15.3 ± 3.4 / -12.3 ± 4.6 / 0.001
B.  Hospital period / Survival (n=4) / Death (n=7) / p / Survival (n=68) / Death (n=32) / p
GLS (%) / -11.1 ± 4.4 / -9.5 ± 3.5 / 0.54 / -15.1 ± 3.2 / -13.0 ± 5.0 / 0.01

Abbreviations: LVEF, left ventricular ejection fraction; GLS, global left ventricular peak systolic longitudinal strain


Supplemental table 4. The global left ventricular peak systolic longitudinal strain (GLS) between survivors and non-survivors of the septic shock patients with hyper-kinetic heart (LVEF>70%) or non-hyper-kinetic heart (LVEF 50-70%) during the period of (A) ICU admission or (B) hospitalization.

LVEF 50-70 % / LVEF >70%
C.  ICU period / Survival (n=51) / Death (n=18) / p / Survival (n=21) / Death (n=10) / p
GLS (%) / -14.8 ± 4.4 / -12.1 ± 4.6 / 0.001 / -15.0 ± 4.4 / -14.0 ± 4.5 / 0.03
D.  Hospital period / Survival (n=48) / Death (n=21) / p / Survival (n=20) / Death (n=11) / P
GLS (%) / -14.9 ± 3.8 / -12.0 ± 5.3 / 0.001 / -16.0 ± 5.0 / -13.3 ± 4.7 / 0.01

Abbreviations: LVEF, left ventricular ejection fraction; GLS, global left ventricular peak systolic longitudinal strain

Supplemental table 5. Univariable and multivariable predictors of mortality for the septic shock patients with preserved LVEF (LVEF≥50%) during intensive care unit (ICU) and hospitalization periods

ICU mortality / Hospital mortality
Univaribale / Multivariable / Univaribale / Multivariable
HR
(95% CI) / p / HR
(95% CI) / p / HR
(95% CI) / p / HR
(95% CI) / p
Age / 1.00
(0.98-1.02) / 0.75 / -- / -- / 1.00
(0.98-1.02) / 0.99 / -- / --
Male gender / 0.66
(0.32-1.35) / 0.26 / -- / -- / 0.66
(0.33-1.30) / 0.23 / -- / --
Hypertension / 0.89
(0.41-1.93) / 0.76 / -- / -- / 0.54
(0.26-1.15) / 0.11 / -- / --
Alcoholism / 1.12
(0.48-2.65) / 0.79 / -- / -- / 1.65
(0.77-3.55) / 0.20 / -- / --
APACHE II score (24 hours) / 1.05
(1.01-1.10) / 0.03 / 1.06
(1.02-1.11) / 0.006 / 1.05
(1.02-1.09) / 0.006 / 1.07
(1.03-1.12) / 0.002
Heart rate / 1.01
(0.99-1.03) / 0.28 / -- / -- / 1.02
(0.99-1.20) / 0.07 / 1.02
(0.99-1.04) / 0.053
GLS / 1.15
(1.07-1.23) / <0.001 / 1.14
(1.06-1.23) / <0.001 / 1.22
(1.04-1.20) / 0.002 / 1.12
(1.04-1.20) / 0.002

Abbreviations: CI, confidence interval; GLS, global left ventricular peak systolic longitudinal strain; HR, hazard ratio; LVEF, left ventricular ejection fraction.

Supplemental figure legends

Supplemental figure 1. The values of global longitudinal strain (GLS) in survivors and non-survivors during (A) the intensive care unit stay or (B) in-hospital duration.