Outcomes and Predictors of Mortality Among Cardiac Intensive Care Unit Patients With Heart Failure
Graphical Abstract
Section snippets
Methods
This study was approved by the Institutional Review Board of the Mayo Clinic as minimal risk and was performed under a waiver of informed consent. We retrospectively analyzed a previously constructed cohort including data from the index CICU admission of adults who were admitted to the CICU at Mayo Clinic St. Mary's Hospital (Rochester, MN) from January 2007 to April 2018.12,16 We included only patients with an admission diagnosis of HF, defined as any International Classification of Diseases,
Study Population
Out of a database of 12,322 unique CICU patient admissions with available admission diagnosis data, 6008 (48.8%) had an admission diagnosis of HF. Among these patients, 4272 (71.1%) had a TTE within 1 day of hospitalization and the 4012 of these patients with data for LVEF were included in the final study population. The final study population had a median age of 71.9 years (IQR, 61.7–81.1 years), and 60.8% were men (Table 1). Concomitant admission diagnoses (in addition to HF) included acute
Discussion
In this study of more than 4000 CICU patients admitted with HF, we observed a substantial risk of in-hospital and postdischarge mortality such that one-third of all patients with HF admitted to the CICU died within 1 year after CICU admission. Approximately one-third of patients with HF had HFpEF, and the remainder had HFrEF (including those with HFmrEF). Although these 2 groups differed slightly, including a greater prevalence of critical care diagnoses and slightly more use of critical care
Conclusions
CICU patients admitted with HF are not restricted to those with severe systolic dysfunction, with approximately one-third of patients displaying HFpEF. Within the CICU HF cohort, there is a high proportion of patients with HF with critical illness requiring intensive therapies regardless of LVEF. This cohort demonstrated a high incidence of short- and long-term mortality and rehospitalization in patients with HFrEF and patients with HFpEF, although patients without critical illness were at a
Declaration of Competing Interest
None of the authors has a relevant financial disclosure or conflict of interest pertinent to this research.
Funding
No funding was involved in the conduct of this research.
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