Li Yide, Zhu Yuan, Fu Le, Luo Liang, She Yingfang
Department of Critical Care Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
Neurology Medicine Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
Am Heart J Plus. 2024 Jul 29;45:100432. doi: 10.1016/j.ahjo.2024.100432. eCollection 2024 Sep.
Acute heart failure necessitates intensive care, and arterial catheterization is a commonly performed invasive procedure in the intensive care unit (ICU). We aimed to investigate the association between arterial catheterization and outcomes in acute heart failure patients without shock.
We utilized MIMIC-IV database records for acute heart failure patients at Beth Israel Deaconess Medical Center from 2008 to 2019. Employing doubly robust estimation, we examined the relationship between arterial catheterization and outcomes, including 28-day, 90-day, in-hospital mortality, and ICU-free days within 28 days.
Of 6936 patients identified, 2078 met inclusion criteria; 347 underwent arterial catheterization during their ICU stay. We observed no significant difference in 28-day mortality (odds ratio [OR]: 0.61, 95 % confidence interval [CI]: 0.31-1.21, = 0.155), though catheterization was associated with reduced in-hospital mortality (OR: 0.41, 95 % CI: 0.14-0.65, = 0.02). No significant effects were observed on 90-day mortality or ICU-free days within 28 days.
Our findings suggest that arterial catheterization is not associated with 28- and 90-day mortality rates in acute heart failure patients without shock but is linked to lower in-hospital mortality. Additional research and consensus are required to determine the appropriate utilization of arterial catheterization in patients.
急性心力衰竭需要重症监护，动脉导管插入术是重症监护病房（ICU）中常见的侵入性操作。我们旨在研究动脉导管插入术与无休克的急性心力衰竭患者预后之间的关联。
我们利用了贝斯以色列女执事医疗中心2008年至2019年急性心力衰竭患者的MIMIC-IV数据库记录。采用双重稳健估计，我们研究了动脉导管插入术与预后之间的关系，包括28天、90天、住院死亡率以及28天内无ICU天数。
在确定的6936例患者中，2078例符合纳入标准；347例在ICU住院期间接受了动脉导管插入术。我们观察到28天死亡率无显著差异（优势比[OR]：0.61，95%置信区间[CI]：0.31-1.21，P = 0.155），尽管导管插入术与住院死亡率降低相关（OR：0.41，95%CI：0.14-0.65，P = 0.02）。在90天死亡率或28天内无ICU天数方面未观察到显著影响。
我们的研究结果表明，动脉导管插入术与无休克的急性心力衰竭患者的28天和90天死亡率无关，但与较低的住院死亡率相关。需要进一步的研究和共识来确定患者动脉导管插入术的适当应用。
