Left ventricular outflow tract velocity-time integral was the strongest predictor of in-hospital mortality (adjusted OR 0.912 per 1 cm higher; 95% CI 0.883-0.942; P<0.0001).
Cohort (n=6,957)
No
Do Doppler-derived hemodynamic TTE parameters predict in-hospital mortality in cardiac intensive care unit patients?
Doppler-derived hemodynamic parameters, specifically LVOT VTI <16 cm and mitral E/e' ratio >15, obtained during admission echocardiography strongly predict in-hospital mortality in CICU patients.
Effect estimate: adjusted OR 0.912 (95% CI 0.883-0.942)
p-value: p=<0.0001
AIMS: Cardiac point-of-care ultrasound (CV-POCUS) has become a fundamental part for the assessment of patients admitted to cardiac intensive care units (CICU). We sought to refine the practice of CV-POCUS by identifying 2D and Doppler-derived measurements from bedside transthoracic echocardiograms (TTEs) performed in the CICU that are associated with mortality. METHODS AND RESULTS: We retrospectively included Mayo Clinic CICU patients admitted from 2007 to 2018 and assessed the TTEs performed within 1 day of CICU admission, including Doppler and 2D measurements of left and right ventricular function. Logistic regression and classification and regression tree (CART) analysis were used to determine the association between TTE variables with in-hospital mortality. A total of 6957 patients were included with a mean age of 68.0 ± 14.9 years (37.0% females). A total of 609 (8.8%) patients died in the hospital. Inpatient deaths group had worse biventricular systolic function [left ventricular ejection fraction (LVEF) 48.2 ± 16.0% vs. 38.7 ± 18.2%, P 15. The incorporation of these simplified Doppler-derived haemodynamics into admission CV-POCUS facilitates early risk stratification and strengthens the clinical yield of the ultrasound exam.
Jentzer et al. (Tue,) conducted a cohort in cardiac intensive care unit patients (n=6,957). Doppler-derived haemodynamic TTE parameters was evaluated on in-hospital mortality (adjusted OR 0.912, 95% CI 0.883-0.942, p=<0.0001). Left ventricular outflow tract velocity-time integral was the strongest predictor of in-hospital mortality (adjusted OR 0.912 per 1 cm higher; 95% CI 0.883-0.942; P<0.0001).