Inotropes and vasopressors are associated with increased short-term mortality but not long-term survival in critically ill patients - 08/02/22
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Abstract |
Objective |
Limited information is currently available on the impact of vasoactive medications in intensive care (ICU) and long-term outcomes. The main objective of our study was to describe the association between the use of inotropes and/or vasopressors and ICU mortality. Secondary objectives were to evaluate the association between the use of vasoactive drugs and in-hospital as well as 1-year all-cause mortality in ICU survivors.
Methods |
FROG-ICU was a prospective, observational, multi-centre cohort designed to investigate long-term mortality of critically ill adult patients. Cox proportional hazards models were used to evaluate the association between the use of inotropes and/or vasopressors and ICU mortality, as well as in-hospital and 1-year all-cause mortality in a propensity-score matched cohort.
Results |
The study included 2087 patients, 939 of whom received inotropes and/or vasopressors during the initial ICU stay. Patients treated with vasoactive medications were older and had a more severe clinical presentation. In a propensity score-matched cohort of 1201 patients, ICU mortality was higher in patients who received vasoactive medications (HR of 1.40 [1.10–1.78], p = 0.007). One thousand six hundred thirty-five patients survived the index ICU hospitalisation. There was no significant difference according to the use of inotropes and/or vasopressors in the propensity-score matched cohort on in-hospital mortality (HR of 0.94 [0.60–1.49], p = 0.808) as well as one-year all-cause mortality (HR 0.94 [0.71–1.24], p = 0.643).
Conclusion |
Inotropic and/or vasopressor therapy is a strong predictor of in-ICU death. However, the use of inotropes and/or vasopressors during ICU admission was not associated with a worse prognosis after ICU discharge.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : CAD, CCI, CHF, CI, CKD, COPD, GCS, HR, ICU, IQR, MICE, SAPS II, SBP, SOFA
Keywords : Inotropes, Vasopressors, Mortality, Long-term outcomes, Propensity score matching
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Vol 41 - N° 1
Articolo 101012- Febbraio 2022 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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