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April 23, 2026Open Access

Clinical Profiles and Prognostic Patterns in Critically Ill Cardiac Patients Requiring Invasive Mechanical Ventilation: A Five-Year Retrospective Cohort Study

Key Points

To characterize clinical profiles and prognostic patterns in critically ill cardiac patients requiring invasive mechanical ventilation and identify variables associated with in-hospital mortality.
Conducted a five-year retrospective observational cohort study
Included 492 adult patients from a tertiary cardiovascular intensive care unit
Analyzed demographics, cardiovascular risk factors, complications, and mortality rates.
Overall in-hospital mortality was 53.9%
Advanced age, diabetes, and cardiogenic shock were significantly associated with increased mortality
Ventilator-associated infections occurred in 16.9% of patients, but did not significantly affect mortality.

Abstract

Background: Critically ill cardiac patients who require invasive mechanical ventilation represent a high-risk population with persistently elevated in-hospital mortality, despite advances in cardiovascular and critical care management. Real-world data describing clinical profiles and prognostic patterns in this population remain limited. Objectives: The aim of this study was to characterize clinical profiles and prognostic patterns among critically ill cardiac patients requiring invasive mechanical ventilation and to identify variables associated with in-hospital mortality. Methods: We conducted a five-year retrospective observational cohort study, including 492 adult patients admitted to a tertiary cardiovascular intensive care unit who required invasive mechanical ventilation. The demographic characteristics, cardiovascular risk factors, primary cardiac diagnoses, major in-hospital complications, duration of mechanical ventilation, length of hospital stay, and in-hospital mortality were analyzed. Results: The overall in-hospital mortality was 53.9%. Acute myocardial infarction was the most frequent primary diagnosis. Advanced age, diabetes mellitus, cardiogenic shock, acute renal dysfunction, hepatic dysfunction and prolonged hospitalization were significantly associated with increased mortality (p < 0.05 for all comparisons). Cardiogenic shock showed the strongest association (p < 0.001). Ventilator-associated respiratory infections occurred in 16.9% of patients, and were associated with a prolonged hospital stay (p < 0.05), without a statistically significant association with mortality. Conclusions: Critically ill cardiac patients requiring invasive mechanical ventilation exhibit distinct high-risk clinical profiles characterized by advanced age, cardiogenic shock, metabolic comorbidities, and the development of multi-organ dysfunction. These findings highlight prognostic patterns that may support risk stratification and generate hypotheses for future prospective studies in cardiac intensive care.

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