Serial TAPSE and Subsequent 60-Day Mortality Among Critically Ill Adults with Reduced Baseline TAPSE: A MIMIC-IV-ECHO Cohort Study

Background/Objectives: Tricuspid annular plane systolic excursion (TAPSE) is routinely available in critical-care echocardiography, but the prognostic relevance of serial change is uncertain. We examined serial TAPSE and subsequent mortality among critically ill adults with reduced baseline TAPSE.

Methods

This retrospective MIMIC-IV-ECHO cohort included adults with at least two TAPSE measurements and baseline TAPSE < 1.7 cm. Serial TAPSE status was classified as improved (increase >0.2 cm) or non-improved (change ≤0.2 cm). Cox regression evaluated 60-day mortality from the follow-up echocardiogram.

Results

Among 227 patients, 101 (44.5%) were improved and 126 (55.5%) non-improved over a median interval of 10 days. Non-improved status was associated with higher subsequent mortality (adjusted hazard ratio 1.72, 95% confidence interval 1.06–2.80; p = 0.028). After adjustment for follow-up TAPSE, neither binary status nor continuous change was significantly associated with mortality.