Shifting Trends in Intensive Cardiovascular Care Unit Admission Patterns: Retrospective Insights and Prospective...

Area of Science:

• Cardiology
• Critical Care Medicine
• Health Services Research

Background:

• Intensive Cardiovascular Care Units (ICCUs) are vital for high-acuity cardiovascular conditions.
• Limited contemporary data exists on evolving ICCU admission patterns and outcomes.
• Understanding these trends is crucial for optimizing patient care.

Purpose of the Study:

• To analyze changes in ICCU admission patterns and patient characteristics over a five-year period.
• To evaluate the association between evolving admission trends and patient mortality outcomes.
• To identify advancements in cardiovascular interventions and their impact on survival.

Main Methods:

• Retrospective cohort study of 6266 patients admitted to a tertiary-care ICCU (2019-2024).
• Patients stratified into early (2019-2021) and late (2022-2024) admission periods.
• Comparison of baseline characteristics, diagnoses, interventions, and mortality (in-hospital and one-year).

Main Results:

• Later period admissions showed increased comorbidities (atrial fibrillation, cognitive impairment, dialysis).
• Shift in diagnoses towards heart failure and malignant arrhythmias; decline in NSTEMI and PE.
• Increased use of advanced interventions (PCI, TAVI, microaxial pumps); decreased IABP use.
• In-hospital mortality remained stable (2.7%); adjusted one-year mortality significantly reduced in the later period (aHR 0.84, p=0.037).

Conclusions:

• ICCU admissions have increased in complexity and procedural trends over five years.
• Despite higher patient acuity, adjusted one-year survival has improved.
• Continuous data-driven ICCU optimization and care advancements are key to improved outcomes.