Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan
Fluid balance is an essential issue in critical care; however, the impact of early fluid balance on the long-term mortality in critically ill surgical patients remains unknown. This study aimed to address the impact of day 1–3 and day 4–7 fluid balance on the long-term mortality in critically ill su...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/21/4873 |
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| author | Chieh-Liang Wu Kai-Chih Pai Li-Ting Wong Min-Shian Wang Wen-Cheng Chao |
| author_facet | Chieh-Liang Wu Kai-Chih Pai Li-Ting Wong Min-Shian Wang Wen-Cheng Chao |
| author_sort | Chieh-Liang Wu |
| collection | DOAJ |
| description | Fluid balance is an essential issue in critical care; however, the impact of early fluid balance on the long-term mortality in critically ill surgical patients remains unknown. This study aimed to address the impact of day 1–3 and day 4–7 fluid balance on the long-term mortality in critically ill surgical patients. We enrolled patients who were admitted to surgical intensive care units (ICUs) during 2015–2019 at a tertiary hospital in central Taiwan and retrieved date-of-death from the Taiwanese nationwide death registration profile. We used a Log-rank test and a multivariable Cox proportional hazards regression model to determine the independent mortality impact of early fluid balance. A total of 6978 patients were included for analyses (mean age: 60.9 ± 15.9 years; 63.9% of them were men). In-hospital mortality, 90-day mortality, 1-year and overall mortality was 10.3%, 15.8%, 23.8% and 31.7%, respectively. In a multivariable Cox proportional hazard regression model adjusted for relevant covariates, we found that positive cumulative day 4–7 fluid balance was independently associated with long-term mortality (aHR 1.083, 95% CI 1.062–1.105), and a similar trend was found on day 1–3 fluid balance, although to a lesser extent (aHR 1.027, 95% CI 1.011–1.043). In conclusion, the fluid balance in the first week of ICU stay, particularly day 4–7 fluid balance, may affect the long-term outcome in critically ill surgical patients. |
| first_indexed | 2024-03-10T05:59:38Z |
| format | Article |
| id | doaj.art-4d8a83c9f84b4bd3be97ea766e792662 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:59:38Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4d8a83c9f84b4bd3be97ea766e7926622023-11-22T21:03:56ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011021487310.3390/jcm10214873Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central TaiwanChieh-Liang Wu0Kai-Chih Pai1Li-Ting Wong2Min-Shian Wang3Wen-Cheng Chao4Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanCollege of Engineering, Tunghai University, Taichung 407224, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung 40705, TaiwanArtificial Intelligence Studio, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, TaiwanFluid balance is an essential issue in critical care; however, the impact of early fluid balance on the long-term mortality in critically ill surgical patients remains unknown. This study aimed to address the impact of day 1–3 and day 4–7 fluid balance on the long-term mortality in critically ill surgical patients. We enrolled patients who were admitted to surgical intensive care units (ICUs) during 2015–2019 at a tertiary hospital in central Taiwan and retrieved date-of-death from the Taiwanese nationwide death registration profile. We used a Log-rank test and a multivariable Cox proportional hazards regression model to determine the independent mortality impact of early fluid balance. A total of 6978 patients were included for analyses (mean age: 60.9 ± 15.9 years; 63.9% of them were men). In-hospital mortality, 90-day mortality, 1-year and overall mortality was 10.3%, 15.8%, 23.8% and 31.7%, respectively. In a multivariable Cox proportional hazard regression model adjusted for relevant covariates, we found that positive cumulative day 4–7 fluid balance was independently associated with long-term mortality (aHR 1.083, 95% CI 1.062–1.105), and a similar trend was found on day 1–3 fluid balance, although to a lesser extent (aHR 1.027, 95% CI 1.011–1.043). In conclusion, the fluid balance in the first week of ICU stay, particularly day 4–7 fluid balance, may affect the long-term outcome in critically ill surgical patients.https://www.mdpi.com/2077-0383/10/21/4873critical illnesssurgicalfluid balancemortalitylong-term outcomeshock |
| spellingShingle | Chieh-Liang Wu Kai-Chih Pai Li-Ting Wong Min-Shian Wang Wen-Cheng Chao Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan Journal of Clinical Medicine critical illness surgical fluid balance mortality long-term outcome shock |
| title | Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan |
| title_full | Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan |
| title_fullStr | Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan |
| title_full_unstemmed | Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan |
| title_short | Impact of Early Fluid Balance on Long-Term Mortality in Critically Ill Surgical Patients: A Retrospective Cohort Study in Central Taiwan |
| title_sort | impact of early fluid balance on long term mortality in critically ill surgical patients a retrospective cohort study in central taiwan |
| topic | critical illness surgical fluid balance mortality long-term outcome shock |
| url | https://www.mdpi.com/2077-0383/10/21/4873 |
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