Table 4.
Associations with CICU mortality in acute decompensated heart failure admissions who did not undergo cardiothoracic surgical procedures.
| All ADHF
Encounters (n=1184) |
CICU Encounter Mortality | p-value | ||
|---|---|---|---|---|
| Yes (n=200) |
No (n=984) |
|||
| Congenital Heart Disease | ||||
| Yes | 585 (49) | 130 (65) | 455 (46) | <0.001 |
| No | 599 (51) | 70 (35) | 529 (54) | |
| Male Gender | 657 (55) | 123 (62) | 534 (54) | 0.06 |
| Extra-cardiac Anomalies | 164 (14) | 39 (20) | 125 (13) | 0.01 |
| Chromosomal Abnormality and/or Syndrome(s) | 189 (16) | 38 (19) | 151 (15) | 0.19 |
| Neonate (< 30 days) | 193 (16) | 63 (32) | 130 (13) | <0.001 |
| Infant (30 days to <1 year) | 326 (28) | 51 (26) | 275 (28) | |
| Child (1 year to <18 years) | 665 (56) | 86 (43) | 579 (59) | |
| Race | ||||
| Caucasian, non-Hispanic | 516 (44) | 87 (44) | 429 (44) | 0.95 |
| Hispanic, any race | 247 (21) | 39 (20) | 208 (21) | |
| Black, non-Hispanic | 271 (23) | 48 (24) | 223 (23) | |
| All other races, non-Hispanic | 150 (13) | 26 (13) | 124 (13) | |
| Pre-existing High-Risk Diagnoses | ||||
| Arrhythmia | 41 (4) | 9 (5) | 32 (3) | 0.38 |
| CPR reason for admit | 50 (4) | 25 (13) | 25 (3) | <0.001 |
| Pulmonary hypertension | 68 (6) | 22 (11) | 46 (5) | <0.001 |
| Heart transplant rejection | 31 (3) | 6 (3) | 25 (3) | 0.71 |
| Cardiomyopathy | 461 (39) | 60 (30) | 401 (41) | 0.005 |
| Myocarditis | 100 (8) | 9 (5) | 91 (9) | 0.03 |
| Any Vasoactive/Inotrope Infusion | 1009 (85) | 193 (97) | 816 (83) | <0.001 |
| Vasoactive/Inotrope Infusion Within 2 hrs. of CICU Admission | 747 (63) | 131 (65.50) | 616 (63) | 0.44 |
| VIS (Peak, within 2 hrs. of CICU Admission) | 5 (5–10) | 7.5 (5–12) | 5 (5–8) | <0.001 |
| VIS Categories | ||||
| > 7.5 | 225 (19) | 63 (32) | 162 (16) | <0.001 |
| < 7.5, > 2.5 | 496 (42) | 62 (31) | 434 (44) | |
| < 2.5 | 463 (39) | 75 (38) | 388 (39) | |
| Mechanical ventilation | 573 (48) | 188 (94) | 385 (39) | <0.001 |
| Mechanical ventilation, duration (hours, median, IQR; n=573) | 113 (40–260) | 134 (40–393) | 105 (41–224) | 0.05 |
| VAD placement | 42 (4) | 6 (3) | 36 (4) | 0.65 |
| ECMO | 20 (10) | 68 (34) | 52 (5) | <0.001 |
| Complications | ||||
| Sepsis | 77 (7) | 31 (16) | 46 (5) | <0.001 |
| Hepatic failure | 36 (3) | 29 (15) | 7 (1) | <0.001 |
| CRRT for acute renal failure | 37 (3) | 21 (11) | 16 (2) | <0.001 |
| Stroke | 50 (4) | 20 (10) | 30 (3) | <0.001 |
| Ventricular tachycardia | 94 (8) | 41 (21) | 53 (5) | <0.001 |
| Cardiac arrest during ICU encounter | 117 (10) | 81 (41) | 36 (4) | <0.001 |
| E-CPR (% of Cardiac Arrest) | 38 (32) | 26 (32) | 12 (33) | 0.89 |
| Cardiac arrest time (minutes, median, IQR) | 21 (4–48) | 30 (13–49) | 5 (1–24) | <0.001 |
Key: CICU, cardiac intensive care unit; CPR, cardiopulmonary resuscitation; CRRT, continuous renal replacement therapy; E-CPR, extracorporeal cardiopulmonary resuscitation; ECMO, extracorporeal membrane oxygenation; VIS, Vasoactive-Inotropic Score (Gaies M., Jeffries H.E., Niebler R.A., et al. Vasoactive-Inotropic Score (VIS) is Associated with Outcome After Infant Cardiac Surgery: An Analysis from the Pediatric Cardiac Critical Care Consortium (PC4) and Virtual PICU System Registries. Pediatric Critical Care Medicine. 2014;15:529–537); VAD, ventricular assist device