Outcomes and prognostic factors of decompensated pulmonary hypertension in the intensive care unit - 08/12/21
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Abstract |
Background |
Patients with acute decompensation of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) admitted to intensive care unit (ICU) have high in-hospital mortality. We hypothesized that pulmonary hypertension (PH) severity, measured by a simplified version of European Society of Cardiology/European Respiratory Society (ESC/ERS) risk assessment, and the severity of organ dysfunction upon ICU admission, measured by sequential organ failure assessment score (SOFA) were associated with in-hospital mortality in decompensated patients with PAH and CTEPH. We also described clinical and laboratory variables during ICU stay.
Methods |
Observational study including adults with decompensated PAH or CTEPH with unplanned ICU admission between 2014 and 2019. Multivariate logistic regression models were used to evaluate the association of ESC/ERS risk assessment and SOFA score with in-hospital mortality. ESC/ERS risk assessment and SOFA score were included in a decision tree to predict in-hospital mortality.
Results |
73 patients were included. In-hospital mortality was 41.1%. ESC/ERS high-risk group (adjusted odds ratio = 95.52) and SOFA score (adjusted odds ratio = 1.80) were associated with in-hospital mortality. The decision tree identified four groups with in-hospital mortality between 8.1% and 100%. Nonsurvivors had a lower central venous oxygen saturation, higher arterial lactate and higher brain natriuretic peptide in the end of first week in the ICU.
Conclusions |
High-risk on a simplified version of ERS/ESC risk assessment and SOFA score upon ICU admission are associate with in-hospital mortality. A decision tree based on ESC/ERS risk assessment and SOFA score identifies four groups with in-hospital mortality between 8.1% and 100%.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In-hospital mortality is 41% in patients with decompensated pulmonary hypertension. |
• | ESC/ERS risk assessment and SOFA predict hospital mortality in decompensated PH. |
• | A decision tree based on PH risk assessment and SOFA can predict hospital mortality. |
• | The decision tree identified patients with high hospital mortality at ICU admission. |
Keywords : Intensive care unit, Pulmonary hypertension, Pulmonary arterial hypertension, Chronic thromboembolic pulmonary hypertension, SOFA score, ECS/ERS risk assessment
Plan
Vol 190
Article 106685- décembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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