Evidence map›Paper›PMID 40828181›Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2026

Beyond APACHE II: the role of TAPSE in predicting mortality among septic patients and septic shock; a systematic review and metanalysis Right heart, right prognosis: TAPSE, a new tool for predicting mortality among septic patients and septic shock; a systematic review and metanalysis.

Alessandro Perencin, Chiara Curreri, Bruno Micael Zanforlini, Anna Bertocco, Chiara Ceolin, Mario Virgilio Papa, Giuseppe Sergi, Marina De Rui

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alessandro PerencinGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Chiara CurreriGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Bruno Micael ZanforliniGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Anna BertoccoGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Chiara CeolinGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Mario Virgilio PapaGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy. mariovirgilio.papa@phd.unipd.it.ORCID http://orcid.org/0000-0002-1579-2202
Giuseppe SergiGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Marina De RuiGeriatrics Division, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBacterial infections are a serious global health problem, especially for older and critically ill patients, who are at increased risk of complications and mortality. Traditional tools like APACHE II and SOFA scores are widely used to predict outcomes in sepsis, but recent attention has focused on the right heart function-specifically, the tricuspid annular plane systolic excursion (TAPSE)-as a simple, bedside marker with potential prognostic value.

objectiveThis systematic review and meta-analysis aimed to explore the prognostic value of TAPSE in patients with sepsis or septic shock, focusing on its predictive ability compared to established clinical indices such as APACHE II, SOFA and left ventricular ejection fraction (LVEF).

methodsA comprehensive literature search was conducted in PubMed, Embase, Cochrane Library and Web of Science up to April 2025. Studies assessing TAPSE in septic patients were included according to predefined criteria. Data on mortality, TAPSE, APACHE II, SOFA and LVEF were extracted and analyzed. Study quality was assessed using the Newcastle-Ottawa Scale.

resultsTen studies with a total of 1812 patients have been included. The analysis revealed that lower TAPSE values were significantly associated with higher mortality (mean difference -0.50 cm; 95% CI: -0.57 to -0.43; p < 0.00001). Similarly, APACHE II scores were higher in non-survivors (mean difference 4.62; 95% CI: 3.17 to 6.07; p < 0.00001). In contrast, LVEF showed no significant correlation with mortality (mean difference -1.46; p = 0.20). Despite variability among studies, the prognostic value of TAPSE remained consistently evident.

conclusionsTAPSE emerges as a practical, non-invasive tool for assessing right ventricular function and predicting mortality in patients with sepsis. Its simplicity and bedside availability make it a valuable complement to traditional severity scores like APACHE II. Unlike LVEF, which appears less informative in this setting, TAPSE could enhance early risk stratification and guide clinical decision-making, particularly in vulnerable populations such as the elderly and critically ill.

Indexed as

APACHEEchocardiographySepsisShock, SepticTricuspid ValveVentricular Function, RightHumansPredictive Value of TestsPrognosisMortality predictionRight ventricular functionSepsisSeptic shockTAPSE

Identifiers

PMID40828181

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.