Association Between Hemodynamic Monitoring Need and Prognosis of Patients with Sepsis in the Intensive Care Unit

A MIMIC-IV Database Analysis

抄録

Sepsis, a life-threatening disease characterized by organ dysfunction, is primarily caused by an abnormally regulated host response to infection. This study aimed to evaluate the association between hemodynamic monitoring (HM) and the prognosis of patients with sepsis in the intensive care unit (ICU). This retrospective analysis used data from the MIMIC-IV database (2008-2019) at a tertiary medical center in Boston, focusing on adult patients with sepsis. Hemodynamic monitoring was conducted using PICCO. The primary outcome was in-hospital mortality, and the secondary outcomes were ICU mortality, hospital stay, and ICU length of stay. In our study, 16,065 patients were selected for the cohort, and 109 of them underwent HM. After 1:1 matching using a genetic algorithm, the final matched cohort included 98 patients who received HM and 98 patients who did not. The HM group had significantly higher hospital (38.64% versus 14.77%, P < 0.001) and ICU mortality (32.6% versus 17.35%, P < 0.001). In conclusion, patients with sepsis who underwent HM had a worse prognosis. The association between HM and higher mortality rates necessitates further research to understand the underlying reasons and to optimize the use of HM strategies in sepsis management in the ICU.