The Value of Cardiac Index to Predict Early and 30-Day Mortality in Non-Cardiac Patients Admitting to Intensive Care Units

Vahan Moradians, Seyed Ali Javad Moosavi, Mohammad Niyakan Lahiji, Maryam Izadi

Abstract

Background: Cardiac index (CI) is a parameter indicating the amount of cardiac output exported from left ventricle in one minute to body surface area. The present study aimed to assess the value of CI to predict early and 30-day outcome of non-cardiac patients admitting to intensive care units (ICUs).

Methods: This prospective cohort study was performed on 31 non-cardiac patients who consecutively admitted to ICUs. On admission, the Simplified Acute Physiology Score (SAPS) II index was determined. All patients also underwent two-dimensional echocardiography to determine cardiac output. Cardiac Index was calculated by dividing cardiac output by Body Surface Area (BSA). In-hospital mortality and complications were assessed. The patients were followed-up by telephone to determine late death, occurrence of myocardial infarction, readmission, or re-hospitalization.

Results: The mean CI was significantly lower in in-ICU non-survived as compared with survived groups (2.86 ± 0.63 versus 3.70 ± 0.49, p = 0.006). An adverse association was found between SAPS-II and CI (r = -0.539, p = 0.002). However, the length of hospital and ICU stay was not associated with both SAPS-II and CI. Using the ROC curve analysis, CI had a high value to predict in-ICU mortality (AUC = 0.857, p = 0.007). The best cutoff value for CI to predict in-ICU death was 3.35 yielding a sensitivity of 83.3% and a specificity of 80.0%.

Conclusion: Measuring CI on admission even in non-cardiac ICU patients can predict in-ICU mortality with high sensitivity and specificity.

Keywords

Intensive care unit, Cardiac index, Prediction, Mortality

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