Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study
Background. Heart failure (HF) is a leading cause of mortality and morbidity worldwide, with an increasing incidence. Invasive ventilation is considered to be essential for patients with HF. Previous studies have shown that driving pressure is associated with mortality in acute respiratory distress...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2021/5574963 |
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| author | Qilin Yang Jiezhao Zheng Xiaohua Chen Weiyan Chen Deliang Wen Xuming Xiong Zhenhui Zhang |
| author_facet | Qilin Yang Jiezhao Zheng Xiaohua Chen Weiyan Chen Deliang Wen Xuming Xiong Zhenhui Zhang |
| author_sort | Qilin Yang |
| collection | DOAJ |
| description | Background. Heart failure (HF) is a leading cause of mortality and morbidity worldwide, with an increasing incidence. Invasive ventilation is considered to be essential for patients with HF. Previous studies have shown that driving pressure is associated with mortality in acute respiratory distress syndrome (ARDS). However, the relationship between driving pressure and mortality has not yet been examined in ventilated patients with HF. We assessed the association of driving pressure and mortality in patients with HF. Methods. We conducted a retrospective cohort study of invasive ventilated adult patients with HF from the Medical Information Mart for Intensive Care-III database. We used multivariable logistic regression models, a generalized additive model, and a two-piecewise linear regression model to show the effect of the average driving pressure within 24 h of intensive care unit admission on in-hospital mortality. Results. Six hundred and thirty-two invasive ventilated patients with HF were enrolled. Driving pressure was independently associated with in-hospital mortality (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06–1.18; P<0.001) after adjusted potential confounders. A nonlinear relationship was found between driving pressure and in-hospital mortality, which had a threshold around 14.27 cmH2O. The effect sizes and CIs below and above the threshold were 0.89 (0.75 to 1.05) and 1.17 (1.07 to 1.30), respectively. Conclusions. There was a nonlinear relationship between driving pressure and mortality in patients with HF who were ventilated for more than 48 h, and this relationship was associated with increased in-hospital mortality when the driving pressure was more than 14.27 cmH2O. |
| format | Article |
| id | doaj-art-f40af78c41174d709217b569a16b0353 |
| institution | Kabale University |
| issn | 1916-7245 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-f40af78c41174d709217b569a16b03532025-02-03T05:43:35ZengWileyCanadian Respiratory Journal1916-72452021-01-01202110.1155/2021/5574963Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort StudyQilin Yang0Jiezhao Zheng1Xiaohua Chen2Weiyan Chen3Deliang Wen4Xuming Xiong5Zhenhui Zhang6Department of Critical CareDepartment of Critical CareDepartment of Critical CareDepartment of Critical CareDepartment of Critical CareDepartment of Critical CareDepartment of Critical CareBackground. Heart failure (HF) is a leading cause of mortality and morbidity worldwide, with an increasing incidence. Invasive ventilation is considered to be essential for patients with HF. Previous studies have shown that driving pressure is associated with mortality in acute respiratory distress syndrome (ARDS). However, the relationship between driving pressure and mortality has not yet been examined in ventilated patients with HF. We assessed the association of driving pressure and mortality in patients with HF. Methods. We conducted a retrospective cohort study of invasive ventilated adult patients with HF from the Medical Information Mart for Intensive Care-III database. We used multivariable logistic regression models, a generalized additive model, and a two-piecewise linear regression model to show the effect of the average driving pressure within 24 h of intensive care unit admission on in-hospital mortality. Results. Six hundred and thirty-two invasive ventilated patients with HF were enrolled. Driving pressure was independently associated with in-hospital mortality (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06–1.18; P<0.001) after adjusted potential confounders. A nonlinear relationship was found between driving pressure and in-hospital mortality, which had a threshold around 14.27 cmH2O. The effect sizes and CIs below and above the threshold were 0.89 (0.75 to 1.05) and 1.17 (1.07 to 1.30), respectively. Conclusions. There was a nonlinear relationship between driving pressure and mortality in patients with HF who were ventilated for more than 48 h, and this relationship was associated with increased in-hospital mortality when the driving pressure was more than 14.27 cmH2O.http://dx.doi.org/10.1155/2021/5574963 |
| spellingShingle | Qilin Yang Jiezhao Zheng Xiaohua Chen Weiyan Chen Deliang Wen Xuming Xiong Zhenhui Zhang Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study Canadian Respiratory Journal |
| title | Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study |
| title_full | Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study |
| title_fullStr | Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study |
| title_full_unstemmed | Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study |
| title_short | Relationship between Driving Pressure and Mortality in Ventilated Patients with Heart Failure: A Cohort Study |
| title_sort | relationship between driving pressure and mortality in ventilated patients with heart failure a cohort study |
| url | http://dx.doi.org/10.1155/2021/5574963 |
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