Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome
Aims: The ability to differentiate high risk and low risk patients in ICCU is beneficial. Hemodynamic profiles can be used to describe patient’s condition immediately. Based on the presence of congestion and poor perfusion, patients can be divided into four hemodynamic profiles. We aim to evaluate...
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Indonesian Heart Association
2017-09-01
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Series: | Majalah Kardiologi Indonesia |
Online Access: | http://ijconline.id/index.php/ijc/article/view/779 |
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English |
format |
Article |
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DOAJ |
author |
Isman Firdaus Gracia Lilihata Ardeno Kristianto Cindya K. Simanjuntak Siska S. Danny Irmalita Irmalita Surya Dharma Dafsah A. Juzar Daniel P.L. Tobing |
spellingShingle |
Isman Firdaus Gracia Lilihata Ardeno Kristianto Cindya K. Simanjuntak Siska S. Danny Irmalita Irmalita Surya Dharma Dafsah A. Juzar Daniel P.L. Tobing Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome Majalah Kardiologi Indonesia |
author_facet |
Isman Firdaus Gracia Lilihata Ardeno Kristianto Cindya K. Simanjuntak Siska S. Danny Irmalita Irmalita Surya Dharma Dafsah A. Juzar Daniel P.L. Tobing |
author_sort |
Isman Firdaus |
title |
Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome |
title_short |
Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome |
title_full |
Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome |
title_fullStr |
Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome |
title_full_unstemmed |
Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care Outcome |
title_sort |
hemodynamic profiles as a predictor of mortality and length of stay in iccu: insight from registry of acute and intensive cardiovascular care outcome |
publisher |
Indonesian Heart Association |
series |
Majalah Kardiologi Indonesia |
issn |
0126-3773 2620-4762 |
publishDate |
2017-09-01 |
description |
Aims: The ability to differentiate high risk and low risk patients in ICCU is beneficial. Hemodynamic profiles can be used to describe patient’s condition immediately. Based on the presence of congestion and poor perfusion, patients can be divided into four hemodynamic profiles. We aim to evaluate the prognostic value of hemodynamic profiles for patient’s mortality and length of stay (LOS) in intensive cardiac care unit (ICCU).
Methods: In this retrospective cohort study, patients who admitted to ICCU of National Cardiovascular Center Harapan Kita Jakarta, Indonesia, were classified into four hemodynamic profiles: dry-warm, dry-cold, wet-warm, and wet-cold. Bivariate analysis was performed to see the significance between hemodinamic profiles with mortality and LOS, continued with multvariate analysis to evaluate the contribution of other significant factors.
Results: Of 742 patients included, the mortality rate was 7.8%. With dry-warm profile as reference, relative risk for mortality was 2.3 (95% CI 1.303-4.076), 5.8 (95% CI 1.992-16.906), and 8.7 (95% CI 3.513-21.567) for wet-warm, dry-cold and wet cold, consecutively. Mean differences of LOS (days) as follows: wet-warm (1.719; 95% CI 1.21-2.23), dry-cold (3.418; 95% CI 1.52-5.32), and wet-cold (4.654; 95% CI 2.64-6.67) compared to dry-warm. Hemodynamic profiles, especially wet-cold profile, consistently predicted mortality and longer LOS in ICCU by multivariable analysis.
Conclusion: The presence of “wet” profile double the risk of death, “cold” profile has five fold risk of death, while the presence of both has the highest risk for mortality and longer LOS. Hemodynamic profiles assessme
Abstrak
Latar Belakang: Kemampuan untuk membedakan pasien resiko tinggi dan resiko rendah di ICCU sangat penting. Profil hemodinamik dapat digunakan untuk mengenali kondisi pasien secara cepat. Berdasarkan adanya tanda kongesti dan perfusi yang buruk pasien dapat dikelompokkan ke dalam empat profil hemodinamik. Studi ini bertujuan untuk mengevaluasi nilai prognostik profil hemodinamik terhadap mortalitas dan lama rawat pasien di Intensive Cardiac Care Unit (ICCU).
Metode : Studi kohort retrospektif ini dilakukan di Rumah Sakit Pusat Jantung dan Pembuluh Darah Nasional Harapan Kita, Jakarta, Indonesia. Pasien yang dirawat di ICCU dikelompokkan ke dalam empat profil hemodinamik: kering-hangat, kering-dingin, basah-hangat dan basah-dingin. Analisis bivariate dilakukan untuk menilai hubungan antara profil hemodinamik dengan mortalitas dan lama rawat di ICCU, dilanjutkan dengan analisis multivariate untuk mengevaluasi kontribusi faktor-faktor lain yang signifikan
Hasil : Total pasien yang ikut dalam studi sebanyak 742 pasien dan tingkat mortalitas sebesar 7,8%. Resiko relatif (RR) mortalitas untuk profil basah-hangat, kering-dingin dan basah-dingin berturut-turut sebesar 2.3 (95% CI 1.303-4.076), 5.8 (95% CI 1.992-16.906), dan 8.7 (95% CI 3.513-21.567) bila dibandingkan terhadap profil kering-hangat sebagai referensi. Rerata perbedaan lama rawat sebesar 1.719 (95% CI 1.21-2.23), 3.418 ( 95% CI 1.52-5.32), (4.654 (95% CI 2.64-6.67) untuk profil basah-hangat, kering-dingin, dan basah dingin berturut-turut bila dibandingkan dengan profil kering-hangat. Profil hemodinamik, terutama profil basah-dingin secara konsisten memprediksi mortalitas dan lama rawat yang lebih panjang setelah analisis multivariat.
Kesimpulan: Profil “basah” memiliki resiko mortalitas dua kali lipat, profil “dingin” memiliki resiko mortalitas lima kali lipat, sedangkan keduanya secara bersamaan memiliki resiko mortalitas dan lama rawat lebih panjang paling tinggi. Profil hemodinamik dapat digunakan sebagai prediktor mortalitas dan lama rawat pasien di ICCU secara efektif.
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url |
http://ijconline.id/index.php/ijc/article/view/779 |
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doaj-c24b76997ebd492383ce87f54bb9e9872020-11-24T21:45:47ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622017-09-0138310.30701/ijc.v38i3.779Hemodynamic Profiles as a Predictor of Mortality and Length Of Stay in ICCU: Insight from Registry of Acute and Intensive Cardiovascular Care OutcomeIsman Firdaus0Gracia Lilihata1Ardeno Kristianto2Cindya K. Simanjuntak3Siska S. Danny4Irmalita Irmalita5Surya Dharma6Dafsah A. Juzar7Daniel P.L. Tobing8Universitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas IndonesiaUniversitas Indonesia Aims: The ability to differentiate high risk and low risk patients in ICCU is beneficial. Hemodynamic profiles can be used to describe patient’s condition immediately. Based on the presence of congestion and poor perfusion, patients can be divided into four hemodynamic profiles. We aim to evaluate the prognostic value of hemodynamic profiles for patient’s mortality and length of stay (LOS) in intensive cardiac care unit (ICCU). Methods: In this retrospective cohort study, patients who admitted to ICCU of National Cardiovascular Center Harapan Kita Jakarta, Indonesia, were classified into four hemodynamic profiles: dry-warm, dry-cold, wet-warm, and wet-cold. Bivariate analysis was performed to see the significance between hemodinamic profiles with mortality and LOS, continued with multvariate analysis to evaluate the contribution of other significant factors. Results: Of 742 patients included, the mortality rate was 7.8%. With dry-warm profile as reference, relative risk for mortality was 2.3 (95% CI 1.303-4.076), 5.8 (95% CI 1.992-16.906), and 8.7 (95% CI 3.513-21.567) for wet-warm, dry-cold and wet cold, consecutively. Mean differences of LOS (days) as follows: wet-warm (1.719; 95% CI 1.21-2.23), dry-cold (3.418; 95% CI 1.52-5.32), and wet-cold (4.654; 95% CI 2.64-6.67) compared to dry-warm. Hemodynamic profiles, especially wet-cold profile, consistently predicted mortality and longer LOS in ICCU by multivariable analysis. Conclusion: The presence of “wet” profile double the risk of death, “cold” profile has five fold risk of death, while the presence of both has the highest risk for mortality and longer LOS. Hemodynamic profiles assessme Abstrak Latar Belakang: Kemampuan untuk membedakan pasien resiko tinggi dan resiko rendah di ICCU sangat penting. Profil hemodinamik dapat digunakan untuk mengenali kondisi pasien secara cepat. Berdasarkan adanya tanda kongesti dan perfusi yang buruk pasien dapat dikelompokkan ke dalam empat profil hemodinamik. Studi ini bertujuan untuk mengevaluasi nilai prognostik profil hemodinamik terhadap mortalitas dan lama rawat pasien di Intensive Cardiac Care Unit (ICCU). Metode : Studi kohort retrospektif ini dilakukan di Rumah Sakit Pusat Jantung dan Pembuluh Darah Nasional Harapan Kita, Jakarta, Indonesia. Pasien yang dirawat di ICCU dikelompokkan ke dalam empat profil hemodinamik: kering-hangat, kering-dingin, basah-hangat dan basah-dingin. Analisis bivariate dilakukan untuk menilai hubungan antara profil hemodinamik dengan mortalitas dan lama rawat di ICCU, dilanjutkan dengan analisis multivariate untuk mengevaluasi kontribusi faktor-faktor lain yang signifikan Hasil : Total pasien yang ikut dalam studi sebanyak 742 pasien dan tingkat mortalitas sebesar 7,8%. Resiko relatif (RR) mortalitas untuk profil basah-hangat, kering-dingin dan basah-dingin berturut-turut sebesar 2.3 (95% CI 1.303-4.076), 5.8 (95% CI 1.992-16.906), dan 8.7 (95% CI 3.513-21.567) bila dibandingkan terhadap profil kering-hangat sebagai referensi. Rerata perbedaan lama rawat sebesar 1.719 (95% CI 1.21-2.23), 3.418 ( 95% CI 1.52-5.32), (4.654 (95% CI 2.64-6.67) untuk profil basah-hangat, kering-dingin, dan basah dingin berturut-turut bila dibandingkan dengan profil kering-hangat. Profil hemodinamik, terutama profil basah-dingin secara konsisten memprediksi mortalitas dan lama rawat yang lebih panjang setelah analisis multivariat. Kesimpulan: Profil “basah” memiliki resiko mortalitas dua kali lipat, profil “dingin” memiliki resiko mortalitas lima kali lipat, sedangkan keduanya secara bersamaan memiliki resiko mortalitas dan lama rawat lebih panjang paling tinggi. Profil hemodinamik dapat digunakan sebagai prediktor mortalitas dan lama rawat pasien di ICCU secara efektif. http://ijconline.id/index.php/ijc/article/view/779 |