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

## TL;DR

This study finds that mechanical ventilation in cardiac ICU patients is strongly linked to higher in-hospital mortality, suggesting it should be used cautiously.

## Contribution

The study confirms through propensity score matching that mechanical ventilation independently increases mortality risk in cardiac ICU patients.

## Key findings

- Mechanical ventilation is associated with a 4.16-fold increase in in-hospital mortality in cardiac ICU patients.
- Patients with acute respiratory failure and shock have the highest mortality risk when receiving mechanical ventilation.
- The study used a large sample of 12,480 patients from the eICU database to ensure reliable results.

## Abstract

•Mechanical Ventilation (MV) significantly increases in-hospital mortality in Cardiac Intensive Care Unit (CICU) patients (OR = 4.16).•Propensity score matching confirmed that MV is independently associated with mortality risk (p < 0.001).•Patients with acute respiratory failure and shock had the highest mortality risk with MV (OR > 4).•Large-sample analysis based on the eICU database (n = 12,480), ensuring reliable results.•The study supports cautious use of MV in CICU and optimization of respiratory management strategies.

Mechanical Ventilation (MV) significantly increases in-hospital mortality in Cardiac Intensive Care Unit (CICU) patients (OR = 4.16).

Propensity score matching confirmed that MV is independently associated with mortality risk (p < 0.001).

Patients with acute respiratory failure and shock had the highest mortality risk with MV (OR > 4).

Large-sample analysis based on the eICU database (n = 12,480), ensuring reliable results.

The study supports cautious use of MV in CICU and optimization of respiratory management strategies.

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.

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.

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.

These results demonstrate that CICU patients receiving MV have a higher mortality risk, underscoring the need for judicious clinical use of MV.