Association between intra-arterial catheterization and mortality of acute heart failure patients without shock in ICU: A retrospective study

TL;DR

This study found that arterial catheterization in ICU patients with acute heart failure but no shock is linked to lower in-hospital mortality, though it does not affect 28- or 90-day mortality rates.

Contribution

The study provides new evidence on the impact of arterial catheterization on mortality in acute heart failure patients without shock using a large ICU database.

Findings

Arterial catheterization was not associated with 28- or 90-day mortality in acute heart failure patients without shock.

Catheterization was linked to reduced in-hospital mortality in these patients.

No significant association was found between catheterization and ICU-free days within 28 days.

Abstract

Acute heart failure necessitates intensive care, and arterial catheterization is a commonly performed invasive procedure in the intensive care unit (ICU). We aimed to investigate the association between arterial catheterization and outcomes in acute heart failure patients without shock.

We utilized MIMIC-IV database records for acute heart failure patients at Beth Israel Deaconess Medical Center from 2008 to 2019. Employing doubly robust estimation, we examined the relationship between arterial catheterization and outcomes, including 28-day, 90-day, in-hospital mortality, and ICU-free days within 28 days.

Of 6936 patients identified, 2078 met inclusion criteria; 347 underwent arterial catheterization during their ICU stay. We observed no significant difference in 28-day mortality (odds ratio [OR]: 0.61, 95 % confidence interval [CI]: 0.31–1.21, P = 0.155), though catheterization was associated with reduced in-hospital mortality (OR: 0.41, 95 % CI: 0.14–0.65, P = 0.02). No significant effects were observed on 90-day mortality or ICU-free days within 28 days.

Our findings suggest that arterial catheterization is not associated with 28- and 90-day mortality rates in acute heart failure patients without shock but is linked to lower in-hospital mortality. Additional research and consensus are required to determine the appropriate utilization of arterial catheterization in patients.

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