Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database
Abstract Background Acute respiratory distress syndrome (ARDS) has high mortality and is mainly related to the circulatory failure.Therefore, real-time monitoring of cardiac function and structural changes has important clinical significance.Transthoracic echocardiography (TTE) is a simple and nonin...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-022-02028-5 |
| _version_ | 1811334515246759936 |
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| author | Daoran Dong Yan Wang Chan Wang Yuan Zong |
| author_facet | Daoran Dong Yan Wang Chan Wang Yuan Zong |
| author_sort | Daoran Dong |
| collection | DOAJ |
| description | Abstract Background Acute respiratory distress syndrome (ARDS) has high mortality and is mainly related to the circulatory failure.Therefore, real-time monitoring of cardiac function and structural changes has important clinical significance.Transthoracic echocardiography (TTE) is a simple and noninvasive real-time cardiac examination which is widely used in intensive care unit (ICU) patients.The purpose of this study was to analyze the effect of TTE on the prognosis of ICU patients with ARDS. Methods The data of ARDS patients were retrieved from the MIMIC-III v1.4 database and patients were divided into the TTE group and non-TTE group. The baseline data were compared between the two groups. The effect of TTE on the prognosis of ARDS patients was analyzed through multivariate logistic analysis and the propensity score (PS). The primary outcome was the 28-d mortality rate. The secondary outcomes included pulmonary artery catheter (PAC) and Pulse index continuous cardiac output (PiCCO) administration, the ventilator-free and vasopressor-free days and total intravenous infusion volume on days 1, 2 and 3 of the mechanical ventilation. To illuminate the effect of echocardiography on the outcomes of ARDS patients,a sensitivity analysis was conducted by excluding those patients receiving either PiCCO or PAC. We also performed a subgroup analysis to assess the impact of TTE timing on the prognosis of patients with ARDS. Results A total of 1,346 ARDS patients were enrolled, including 519 (38.6%) cases in the TTE group and 827 (61.4%) cases in the non-TTE group. In the multivariate logistic regression, the 28-day mortality of patients in the TTE group was greatly improved (OR 0.71, 95%CI 0.55–0.92, P = 0.008). More patients in the TTE group received PAC (2% vs. 10%, P < 0.001) and the length of ICU stay in the TTE group was significantly shorter than that in the non-TTE group (17d vs.14d, P = 0.0001). The infusion volume in the TTE group was significantly less than that of the non-TTE group (6.2L vs.5.5L on day 1, P = 0.0012). Importantly, the patients in the TTE group were weaned ventilators earlier than those in the non-TTE group (ventilator-free days within 28 d: 21 d vs. 19.8 d, respectively, P = 0.071). The Kaplan–Meier survival curves showed that TTE patients had significant lower 28-day mortality than non-TTE patients (log-rank = 0.004). Subgroup analysis showed that TTE after hemodynamic disorders can not improve prognosis (OR 1.02, 95%CI 0.79–1.34, P = 0.844). Conclusion TTE was associated with improved 28-day outcomes in patients with ARDS. |
| first_indexed | 2024-04-13T17:10:12Z |
| format | Article |
| id | doaj.art-96791ceac88647899db7d50733a73e95 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-13T17:10:12Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-96791ceac88647899db7d50733a73e952022-12-22T02:38:19ZengBMCBMC Pulmonary Medicine1471-24662022-06-0122111210.1186/s12890-022-02028-5Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III databaseDaoran Dong0Yan Wang1Chan Wang2Yuan Zong3Department of ICU, Shaanxi Provincial People’s HospitalDepartment of ICU, Shaanxi Provincial People’s HospitalDepartment of ICU, Shaanxi Provincial People’s HospitalDepartment of ICU, Shaanxi Provincial People’s HospitalAbstract Background Acute respiratory distress syndrome (ARDS) has high mortality and is mainly related to the circulatory failure.Therefore, real-time monitoring of cardiac function and structural changes has important clinical significance.Transthoracic echocardiography (TTE) is a simple and noninvasive real-time cardiac examination which is widely used in intensive care unit (ICU) patients.The purpose of this study was to analyze the effect of TTE on the prognosis of ICU patients with ARDS. Methods The data of ARDS patients were retrieved from the MIMIC-III v1.4 database and patients were divided into the TTE group and non-TTE group. The baseline data were compared between the two groups. The effect of TTE on the prognosis of ARDS patients was analyzed through multivariate logistic analysis and the propensity score (PS). The primary outcome was the 28-d mortality rate. The secondary outcomes included pulmonary artery catheter (PAC) and Pulse index continuous cardiac output (PiCCO) administration, the ventilator-free and vasopressor-free days and total intravenous infusion volume on days 1, 2 and 3 of the mechanical ventilation. To illuminate the effect of echocardiography on the outcomes of ARDS patients,a sensitivity analysis was conducted by excluding those patients receiving either PiCCO or PAC. We also performed a subgroup analysis to assess the impact of TTE timing on the prognosis of patients with ARDS. Results A total of 1,346 ARDS patients were enrolled, including 519 (38.6%) cases in the TTE group and 827 (61.4%) cases in the non-TTE group. In the multivariate logistic regression, the 28-day mortality of patients in the TTE group was greatly improved (OR 0.71, 95%CI 0.55–0.92, P = 0.008). More patients in the TTE group received PAC (2% vs. 10%, P < 0.001) and the length of ICU stay in the TTE group was significantly shorter than that in the non-TTE group (17d vs.14d, P = 0.0001). The infusion volume in the TTE group was significantly less than that of the non-TTE group (6.2L vs.5.5L on day 1, P = 0.0012). Importantly, the patients in the TTE group were weaned ventilators earlier than those in the non-TTE group (ventilator-free days within 28 d: 21 d vs. 19.8 d, respectively, P = 0.071). The Kaplan–Meier survival curves showed that TTE patients had significant lower 28-day mortality than non-TTE patients (log-rank = 0.004). Subgroup analysis showed that TTE after hemodynamic disorders can not improve prognosis (OR 1.02, 95%CI 0.79–1.34, P = 0.844). Conclusion TTE was associated with improved 28-day outcomes in patients with ARDS.https://doi.org/10.1186/s12890-022-02028-5EchocardiographyAcute respiratory distress syndromeCritical carePrognosis |
| spellingShingle | Daoran Dong Yan Wang Chan Wang Yuan Zong Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database BMC Pulmonary Medicine Echocardiography Acute respiratory distress syndrome Critical care Prognosis |
| title | Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database |
| title_full | Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database |
| title_fullStr | Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database |
| title_full_unstemmed | Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database |
| title_short | Effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome: a propensity score matched analysis of the MIMIC-III database |
| title_sort | effects of transthoracic echocardiography on the prognosis of patients with acute respiratory distress syndrome a propensity score matched analysis of the mimic iii database |
| topic | Echocardiography Acute respiratory distress syndrome Critical care Prognosis |
| url | https://doi.org/10.1186/s12890-022-02028-5 |
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