scholarly journals The association between serum albumia and length of stay of intensive care units in patients with heart failure

2021 ◽  
Author(s):  
Tao Liu ◽  
Haochen Xuan ◽  
Lili Wang ◽  
Xiaoqun Li ◽  
Zhihao Lu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Medical Information ◽  
Smooth Curve ◽  
High Serum ◽  
Outcome Variable ◽  
Trend Test ◽  
Patients With Heart Failure

Abstract Objective: To assess the relationship between serum albumia and length of stay (LOS) of the intensive care units (ICUs).Design and Participants: we retrospectively analyze 2843 patients from the medical information mart for intensive care III (the MIMIC-III ) database. Materials and Methods: The exposure variable of the present study was serum albumia, which was defined as serum albumia level at the time of admission to ICUs. The outcome variable was LOS of ICUs. The final models were established by multivariate linear regression, and trend test and smooth fitting curves were used to evaluate the association between serum albumia level and LOS of ICUs. The subgroups were conducted based on age, sex and body mass index (BMI). Results: Higher serum albumia level can reduce LOS of ICUs in patients with heart failure (HF) than lower serum albumia level (β: -1.18; 95%CI: -1.50, -0.86; P <0.001). Trend test and smooth curve fittings suggested that LOS of ICUs was gradually shorten when serum albumia level was gradually increased. The subgroups based on age, sex and BMI demonstrated similar results between serum albumia level and LOS of ICUs.Conclusion: The negative correlation between serum albumia level and LOS of ICUs among patients with HF was found. High serum albumia level might reduce LOS of ICUs in patients with HF, and the conclusion might guide clinical treatments and judge prognosis.

scholarly journals The association between serum albumin and LOS of patients with acute heart failure: a retrospective study based on the MIMIV-IV database

2021 ◽  
Author(s):  
Tao Liu ◽  
haochen xuan ◽  
lili wang ◽  
xiaoqun li ◽  
zhihao lu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Serum Albumin ◽  
Acute Heart Failure ◽  
Medical Information ◽  
Interactive Effect ◽  
Albumin Level ◽  
Outcome Variable ◽  
Trend Test ◽  
Exposure Variable

Abstract Objective: To assess the relationship between serum albumin and length of stay (LOS) of the intensive care unit (ICU).Design and Participants: we retrospectively analyze 2280 patients with acute heart failure(AHF) from the medical information mart for intensive care IV (the MIMIC-IV ) database. Materials and Methods: The exposure variable of the present study was serum albumin. The outcome variable was LOS. The final models were established by multivariate linear regression, and subgroup analysis was performed. Trend test and smooth fitting curves were used to evaluate the association between serum albumin and LOS. Results: When the value of serum albumin was less than 5.1g/dl, the analysis of 2280 patients showed that the linear relationship between albumin and LOS. LOS was gradually shortened with the albumin increasing (β: -0.636; 95%CI: -0.819, -0.453; P <0.001). In subgroup, sepsis and serum albumininitial had an interactive effect on LOS (P=0.036), and there was significantly different between AHF patients with sepsis (β:-1.927; 95%CI:-3.823, -0.030) and without sepsis(β: -1.412; 95%CI:-1.737, -1.087) .Conclusion: When serum albumin was less than 5.1g/dl, the negative association was presented between serum albumin level and LOS among patients with AHF, and this association is even closer in patients with sepsis.

▾ Enoximone and ▾ milrinone – inotropic vasodilators for severe heart failure

1991 ◽  
Vol 29 (10) ◽  
pp. 39-40
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Severe Heart Failure ◽  
Phosphodiesterase Inhibitors ◽  
First Line ◽  
Short Term ◽  
Failing Heart ◽  
Patients With Heart Failure

Enoximone (Perfan – Merrell) and milrinone (Primacor – Sterling-Winthrop) are phosphodiesterase inhibitors marketed for short-term intravenous use in patients with heart failure on intensive care units. The manufacturers claim that enoximone is ‘a first-line inotrope for the failing heart’ while milrinone is advocated for ‘resistant heart failure’. Are these drugs useful additions to existing treatments?

scholarly journals Changes in the Use of Intensive and Supportive Care with Heart Failure in the Last Month of Life Between 2001 and 2013

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 608-609
Author(s):  
Piling Chou ◽  
Peichao Lin
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Research Database ◽  
Global Epidemic ◽  
Research Guidelines ◽  
Patients With Heart Failure ◽  
End Stage ◽  
Analysis Of Claims Data ◽  
Over Time

Abstract Background Heart failure (HF) is a global epidemic affecting the elder globally. It is uncertain what care patients with heart failure receive at their end of life and what care trends are in the last month of life. OBJECTIVES: This study's objective was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with heart failure in their last month of life during 2001-2013. Methods Analysis of claims data of 25,375 patients with heart failure obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with heart failure in their last month of life during 2001-2013. Results Over the whole study period, 53.3% of patients with heart failure were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (54.3%-41.5%), cardiopulmonary resuscitation (41.5%-16.7%), decreased over time. The percentages of patients receiving artificial hydration and nutrition (52.5.9%-56.8%) and extracorporeal membrane oxygenation(ECMO) (0.52%-1.78%) increased over time. Patients under 75 years old were more likely to be admitted to intensive care units. Conclusion Over time, supportive procedures increased, and intensive procedures decreased in patients with heart failure in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with heart failure.

A machine learning-based model for predicting intensive care unit length of stay in patients with cardiac surgery (Preprint)

2021 ◽  
Author(s):  
Nianyue Wu ◽  
Siru Liu ◽  
Haotian Zhang ◽  
Xiaomin Hou ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Length Of Stay ◽  
Confidence Interval ◽  
Medical Information ◽  
Lasso Regression ◽  
Icu Length Of Stay ◽  
Data Source ◽  
The Mean ◽  
Selection Operator

BACKGROUND The intensive care unit (ICU) length of stay is significant to evaluate the effect of cardiac surgical treatment inpatient. OBJECTIVE This research aims to accurately predict the ICU length of stay in patients with cardiac surgery. Methods: We used machine learning methods to construct the model, and the medical information mart for intensive care (MIMIC IV) database was used as the data source. A total of 7,567 patients were enrolled and the mean length of stay in the ICU was 3.12 days. A total of 126 predictors were included, and 44 important predictors were screened by least absolute shrinkage and selection operator (Lasso) regression. METHODS We used machine learning methods to construct the model, and the medical information mart for intensive care (MIMIC IV) database was used as the data source. A total of 7,567 patients were enrolled and the mean length of stay in the ICU was 3.12 days. A total of 126 predictors were included, and 44 important predictors were screened by least absolute shrinkage and selection operator (Lasso) regression. RESULTS The mean accuracy are 0.603 (95% confidence interval (CI): [0.602-0.604]), 0.687 (95% confidence interval (CI): [0.687-0.688]) and 0.688 (95% confidence interval (CI): [0.687-0.689]) for the logistic regression (LR) with all variables, the gradient boosted decision tree (GBDT) with important variables and the GBDT with all variables respectively. CONCLUSIONS The GBDT model with important predictors partly overestimated patients whose length of stay was less than 3 days and underestimated patients whose length of stay was longer than 3 days. But the better prediction performance of GBDT facilitates early intervention of ICU patients with a long period of hospitalization.

scholarly journals The Value of Admission Serological Indicators for Predicting 28-Day Mortality in Intensive Care Patients With Acute Heart Failure: Construction and Validation of a Nomogram

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyuan Wei ◽  
Yu Min ◽  
Jiangchuan Yu ◽  
Qianli Wang ◽  
Han Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Acute Heart Failure ◽  
Sofa Score ◽  
Medical Information ◽  
Troponin T ◽  
Adequate Treatment ◽  
Intensive Care Patients ◽  
Creatine Kinase Mb ◽  
Death Group

Background: Acute heart failure (AHF) is a severe clinical syndrome characterized as rapid onset or worsening of symptoms of chronic heart failure (CHF). Risk stratification for patients with AHF in the intensive care unit (ICU) may help clinicians to predict the 28-day mortality risk in this subpopulation and further raise the quality of care.Methods: We retrospectively reviewed and analyzed the demographic characteristics and serological indicators of patients with AHF in the Medical Information Mart for Intensive Care III (MIMIC III) (version 1.4) between June 2001 and October 2012 and our medical center between January 2019 and April 2021. The chi-squared test and the Fisher's exact test were used for comparison of qualitative variables among the AHF death group and non-death group. The clinical variables were selected by using the least absolute shrinkage and selection operator (LASSO) regression. A clinical nomogram for predicting the 28-day mortality was constructed based on the multivariate Cox proportional hazard regression analysis and further validated by the internal and external cohorts.Results: Age &gt; 65 years [hazard ratio (HR) = 2.47], the high Sequential Organ Failure Assessment (SOFA) score (≥3 and ≤8, HR = 2.21; ≥9 and ≤20, HR = 3.29), lactic acid (Lac) (&gt;2 mmol/l, HR = 1.40), bicarbonate (HCO3-) (&gt;28 mmol/l, HR = 1.59), blood urea nitrogen (BUN) (&gt;21 mg/dl, HR = 1.75), albumin (&lt;3.5 g/dl, HR = 2.02), troponin T (TnT) (&gt;0.04 ng/ml, HR = 4.02), and creatine kinase-MB (CK-MB) (&gt;5 ng/ml, HR = 1.64) were the independent risk factors for predicting 28-day mortality of intensive care patients with AHF (p &lt; 0.05). The novel nomogram was developed and validated with a promising C-index of 0.814 (95% CI: 0.754–0.882), 0.820 (95% CI: 0.721–0.897), and 0.828 (95% CI: 0.743–0.917), respectively.Conclusion: This study provides a new insight in early predicting the risk of 28-day mortality in intensive care patients with AHF. The age, the SOFA score, and serum TnT level are the leading three predictors in evaluating the short-term outcome of intensive care patients with AHF. Based on the nomogram, clinicians could better stratify patients with AHF at high risk and make adequate treatment plans.

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