The association between mechanical ventilation and in-hospital mortality in cardiac intensive care units: A propensity score-matched cohort study

机械通气与心脏重症监护病房院内死亡率之间的关联:一项倾向评分匹配队列研究

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Abstract

OBJECTIVE: Mechanical Ventilation (MV) is a common intervention in Cardiac Intensive Care Units (CICUs); however, its effect on in-hospital mortality remains controversial. This study aimed to investigate the association between MV and in-hospital mortality among patients in the CICU using data from the eICU Collaborative Research Database. METHODS: Patients were categorized based on whether they received MV, and propensity score matching was applied to adjust for baseline differences. The primary outcome was in-hospital mortality, which was analyzed using logistic regression and sensitivity analyses. RESULTS: A total of 12,480 patients in the CICU were included, with 4390 receiving MV and 8090 not receiving MV. In-hospital mortality was notably higher among MV patients (16.0 %) than among those who did not receive MV (4.7 %, p < 0.001). After adjusting for confounding factors, MV remained associated with increased mortality, with an odds ratio of 4.16 (95 % CI 3.40‒5.12) in the matched cohort. Sensitivity analyses confirmed these findings, particularly in patients with acute respiratory failure and shock. CONCLUSION: These results demonstrate that CICU patients receiving MV have a higher mortality risk, underscoring the need for judicious clinical use of MV.

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