Urine output for predicting in-hospital mortality of intensive care patients with cardiogenic shock

作者全名："Hu, Tianyang; Huang, Rongzhong"

作者地址："[Hu, Tianyang; Huang, Rongzhong] Chongqing Med Univ, Affiliated Hosp 2, Precis Med Ctr, Chongqing, Peoples R China; [Huang, Rongzhong] Chongqing Municipal Clin Res Ctr Geriatr & Geronto, Chongqing, Peoples R China"

通信作者："Huang, RZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Precis Med Ctr, Chongqing, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001022026300001

JCR分区：Q1

影响因子：3.4

年份：2023

卷号：9

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：Cardiogenic shock; Urine output; Oxford acute severity of illness score; MIMIC -IV; In -hospital mortality

摘要："Background: The role of urine output (UO) in the first 24 h of admission in the clinical management of cardiogenic shock (CS) patients has not been elucidated. Methods: This study retrospectively analyzed intensive care CS patients in the MIMIC-IV database. Binomial logistic regression analysis was conducted to evaluate whether UO was an independent risk factor for in-hospital mortality in CS patients. The performance of UO in predicting mortality was evaluated by the receiver operating characteristic (ROC) curve and compared with the Oxford Acute Severity of Illness Score (OASIS). The clinical net benefit of UO in predicting mortality was determined using the decision curve analysis (DCA). Survival analysis was performed with Kaplan-Meier curves. Results: After adjusting for confounding factors including diuretic use and acute kidney injury (AKI), UO remained an independent risk factor for in-hospital mortality in CS patients. The areas under the ROC curves (AUCs) of UO for predicting in-hospital mortality were 0.712 (UO, ml/day) and 0.701 (UO, ml/kg/h), which were comparable to OASIS (AUC = 0.695). In terms of clinical net benefit, UO was comparable to OASIS, with different degrees of benefit at different threshold probabilities. Survival analysis showed that the risk of in-hospital death in the low-UO (& LE;857 ml/ day) group was 3.0143 times that of the high-UO (>857 ml/day) group. Conclusions: UO in the first 24 h of admission is an independent risk factor for in-hospital mortality in intensive care CS patients and has moderate predictive value in predicting in-hospital mortality."

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