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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Association of estimated plasma volume status with 30-day mortality risk in patients with cardiogenic shock: an
Canxiu Zhang1, Yujun Shang1, Lu Zhang2
1Department of Critical Medicine, Qingdao Municipal Hospital, Qingdao, 266071, P.R. China.
Background:
Although estimated plasma volume status (ePVS) has been proven a simple and effective predictor of mortality in many diseases. However, the prognostic value of ePVS in critically ill patients with cardiogenic shock (CS) remains unknown. This study aims to assess the association between ePVS and 30-day mortality risk in CS patients.
Method:
This retrospective cohort study extracted data on patients diagnosed with CS from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The endpoint of the study was 30-day mortality from the intensive care unit admission. The ePVS were assessed by Kaplan Hakim (KH-ePVS), and Duarte-ePVS. The optimal cut-off values were determined using the maximum selection method to classify the ePVS into two groups, and their baseline characteristics were compared. Cox proportional hazards model and Kaplan-Meier survival curves were used to assess the association between ePVS levels and 30-day mortality.
Results:
A total of 1,691 participants were recruited in this study, with 596 participants (35.25%) dying within 30 days. Patients with higher Duarte-ePVS levels had a higher risk of 30-day mortality [HR (hazard ratios): 1.36, 95% confidence interval (CI): 1.12-1.65] compared with CS patients with lower Duarte-ePVS levels. However, no association was observed between KH-ePVS and 30-day mortality risk in critically ill CS patients (HR: 1.19, 95%CI: 0.96-1.48). Similar results of the association between ePVS and 30-day mortality were found in participants aged ≥ 65 years, male, and those with heart failure (all P < 0.05). Kaplan-Meier curves showed that Duarte-ePVS ≥ 5.11 or KH-ePVS ≥ -10.04 were associated with an increased risk of death (P < 0.001).
Conclusion:
Higher levels of ePVS are associated with an increased risk of short-term mortality in critically ill CS patients. EPVS could potentially be used as a biomarker to enhance the management of patients with CS, although additional research is necessary to assess its predictive utility. Our study offers initial insights that may support risk assessment and prognosis evaluation in CS patients.
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