The Usefulness of Carotid Artery Doppler Measurement as a Predictor of Early Death in Sepsis Patients Admitted to the Emergency Department

Abstract

Background: This study aims to verify whether the blood flow velocity and the diameter size, measured through intra-carotid artery Doppler measurements performed on sepsis patients visiting the emergency department, are useful as tools for predicting the risk of early death. Methods: As a prospective study, this research was performed on sepsis patients who visited a local emergency medical center from August 2021 to February 2023. The sepsis patients’ carotid artery was measured using Doppler imaging, and they were divided into patients measured for the size of systolic and diastolic mean blood flow velocity and diameter size: those measured for their qSOFA (quick sequential organ failure assessment) score and those measured using the SIRS (systemic inflammatory response syndrome) criteria. By measuring and comparing their mortality prediction accuracies, this study sought to verify the usefulness of blood flow velocity and the diameter size of the intra-carotid artery as tools to predict early death. Results: This study was conducted on 1026 patients, excluding 45 patients out of the total of 1071 patients. All sepsis patients were measured using systolic and diastolic blood flow velocity and diameter by Doppler imaging of the intra-carotid artery, assessed using qSOFA and evaluated using SIRS criteria. The results of the analysis performed to compare the mortality prediction accuracy were as follows. First, the hazard ratio (95% CI) of the intra-carotid artery was significant (p < 0.05), at 1.020 (1.004–1.036); the hazard ratio (95% CI) of qSOFA was significant (p < 0.05), at 3.871 (2.526–5.931); and the hazard ratio (95% CI) of SIRS showed no significant difference, at 1.002 (0.995–1.009). After 2 h of infusion treatment, the diameter size was 4.72 ± 1.23, showing a significant difference (p < 0.05). After 2 h of fluid treatment, the blood flow velocity was 101 m/s ± 21.12, which showed a significant difference (p < 0.05). Conclusions: Measuring the mean blood flow velocity in the intra-carotid arteries of sepsis patients who visit the emergency department is useful for predicting the risk of death at an early stage. And this study showed that Doppler measurement of the diameter size of the carotid artery significantly increased after performing fluid treatment after early recognition.