Noncardiovascular disorders up mortality in CICU patients

Noncardiovascular disorders are common in Japan’s cardiovascular intensive care units (CICU) and worsen mortality and length of stay, a recent study has found.

Researchers assessed 490 consecutively admitted CICU patients (median age 71.0 years, 68.8 percent men), looking at patient characteristics, diagnoses, treatments, and outcomes. Noncardiovascular disorders were defined as noncardiovascular disease during admission or the onset of such complications while admitted.

Of the CICU admissions, 51 were due to noncardiovascular reasons, comprising 3.9 percent of all patients. These reasons included pulmonary diseases, disturbances in consciousness, sepsis, and cerebral infractions.

Mortality rate in the CICU was 4.1 percent, while in-hospital mortality was 4.9 percent. The median length of CICU stay was 4 days. Notably, acute onset of noncardiovascular complications was highly common, reported in 42.2 percent of patients. These included episodes of respiratory failure, acute kidney injury, and sepsis.

Overall, 43.9 percent of all CICU patients had noncardiovascular disorder, taking into account complications and primary diagnoses.

Multivariate logistic regression analysis found that noncardiovascular disorders acute respiratory failure (odds ratio [OR], 11.014, 95 percent confidence interval [CI], 1.295–93.669; p=0.028) and sepsis (OR, 25.678, 95 percent CI, 5.341–123.443; p<0.001) were strongly associated with higher CICU mortality. The same was true for cardiogenic shock and cardiopulmonary arrest.

“To the best of our knowledge, this is the first report to reveal the current situation of a CICU in Japan. Thus, cardiologists that staff CICUs should consider the poor prognosis and long CICU stays of patients with noncardiovascular disorders and treat them in consultation with noncardiovascular specialists, such as intensivists,” the researchers said.