Acute non-CV illness in CICU patients tied to mortality, increased length of stay
Acute noncardiovascular illnesses are common in many patients in the modern cardiac intensive care unit (CICU) and are associated with mortality and increased length of stay (LOS), reports a new study.
Researchers analysed 1,042 admissions between 12 October 2013 and 28 November 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical centre in the US to determine the relationship of acute noncardiovascular illnesses with outcomes, such as LOS, mortality and hospital readmission.
Acute coronary syndrome (ACS; 25 percent), consisting of both non‒ST-segment elevation ACS (14 percent) and ST-segment elevation myocardial infarction (11 percent), was the most frequent primary diagnosis.
The most common noncardiovascular primary diagnosis was sepsis (5 percent), but it only occurred in 16 percent of all admissions. Acute kidney injury and acute respiratory failure each occurred in 30 percent of admissions. Acute respiratory failure, acute kidney injury or sepsis occurred in 50 percent of all admissions (n=524).
The median LOS in the CICU was 2 days (interquartile range [IQR], 1 to 5 days) and in the hospital 6 days (IQR, 3 to 11 days). Mortality in the CICU and the hospital was 7 and 12 percent, respectively. A total of 920 patients survived to hospital discharge, of which 171 (19 percent) were readmitted within 30 days.
Sepsis, acute kidney injury and acute respiratory failure were all linked to mortality. Acute kidney injury, acute respiratory failure and new-onset subclinical atrial fibrillation (occurring in 8 percent of all admissions) correlated with CICU LOS.
Noncardiovascular illnesses have become more prevalent 50 years since the inception of the CICU, and these may contribute to morbidity and mortality, according to researchers.