In-hospital mortality and risk factors in critically ill patients with hypertrophic cardiomyopathy.

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a common genetic disease with estimated prevalence of 0.2-0.5 %. Contemporary management has substantially improved HCM outcomes. However, the impact of HCM on critically ill patients admitted to intensive care units (ICU) has not been well studied.

Methods: Unmatched and propensity score matched patients with or without HCM were examined in the MIMIC-IV database and compared for mortality, morbidity, and length of stay. Multivariable logistic regression was used to identify risk factors associated with in-hospital mortality in patients with HCM.

Results: Of 51,926 critically ill patients, 165 (0.32 %) were also diagnosed with HCM. Compared with those without HCM, patients with HCM had higher body mass index, higher rates of heart failure, atrial fibrillation, and chronic renal disease, and more often had implantable cardioverter defibrillators. There were no significant differences in in-hospital mortality (10.3 % vs 10.2 %) or length of stay (9.3 ± 9.6 vs 9.3 ± 1 0.6 days) between the two groups. Similar results were obtained in propensity score matched patients with or without HCM. Univariable analyses identified respiratory failure, sepsis, use of vasopressors, and circulatory support devices as predictors of in-hospital mortality in adults with HCM. In multivariable logistic regression analysis, respiratory failure and use of vasopressors and circulatory support devices were the predictors of in-hospital mortality in HCM patients.

Conclusions: Presence of HCM did not affect in-hospital mortality in critically ill patients, but the need for vasopressors and circulatory support devices predicted worse in-hospital mortality among critically ill patients with HCM.