Changes in comorbidities, diagnoses, therapies and outcomes in a contemporary cardiac intensive care unit population.

Journal Article (Journal Article)

UNLABELLED: Prior studies have demonstrated that the cardiac intensive care unit (CICU) patient population has evolved over time. We sought to describe the temporal changes in comorbidities, illness severity, diagnoses, procedures and adjusted mortality within our CICU practice in recent years. METHODS: We retrospectively reviewed unique CICU admissions at the Mayo Clinic from January 2007 to April 2018. Comorbidities, severity of illness scores, discharge diagnosis codes and CICU procedures and therapies were recorded, and temporal trends were assessed using linear regression and Cochran-Armitage trend tests. Trends in adjusted hospital mortality over time were assessed using multivariable logistic regression. RESULTS: We included 12,418 patients with a mean age of 67.6 years (including 37.7% females). Temporal trends in the prevalence of several comorbidities and discharge diagnoses were observed, reflecting an increase in the prevalence of non-coronary cardiovascular diseases, critical care diagnoses, and organ failure (all P ≪ .05). The use of several CICU therapies and procedures increased over time, including mechanical ventilation, invasive lines and vasoactive drugs (all P ≪ .05). A temporal decrease in adjusted hospital mortality was observed among the subgroup of patients with (adjusted OR per year 0.97, 95% CI 0.94-0.99, P = .023) and without (adjusted OR per year 0.91, 95% CI 0.85-0.96, P = .002) a critical care discharge diagnosis. CONCLUSIONS: We observed an increasing prevalence of critical care and organ failure diagnoses as well as increased utilization of critical care therapies in this CICU cohort, associated with a decrease in risk-adjusted hospital mortality over time.

Full Text

Duke Authors

Cited Authors

  • Jentzer, JC; van Diepen, S; Barsness, GW; Katz, JN; Wiley, BM; Bennett, CE; Mankad, SV; Sinak, LJ; Best, PJ; Herrmann, J; Jaffe, AS; Murphy, JG; Morrow, DA; Wright, RS; Bell, MR; Anavekar, NS

Published Date

  • September 2019

Published In

Volume / Issue

  • 215 /

Start / End Page

  • 12 - 19

PubMed ID

  • 31260901

Electronic International Standard Serial Number (EISSN)

  • 1097-6744

Digital Object Identifier (DOI)

  • 10.1016/j.ahj.2019.05.012


  • eng

Conference Location

  • United States