Association between time weighted average mechanical power normalized to compliance and prognosis of critically ill patients: A retrospective cohort study based on the MIMIC-IV database.
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Abstract
Objective: This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MPCRS) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.
Design: Retrospective observational study.
Setting: Intensive care unit (ICU).
Patients or participants: 4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.
Interventions: None.
Main variables of interest: TWA-MPCRS, ICU mortality and in-hospital mortality.
Results: Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MPCRS was 0.3 (0.2, 0.6) J/min/mL/cmH2O. When TWA-MPCRS was divided into quintiles (with quintile 1 representing the lowest values), after adjusting for covariates, the odds ratios [95% confidence intervals (CIs)] for ICU mortality were 1.49 (95% CI: 1.15-1.94), 1.67 (95% CI: 1.29-2.16), 1.79 (95% CI: 1.37-2.33), and 3.96 (95% CI: 3.01-5.21) for quintiles 2, 3, 4, and 5 respectively, with quintile 1 as reference. Similar results were found for hospital mortality.
Conclusion: Higher TWA-MPCRS is associated with poor clinical outcomes in critically ill patients. Higher TWA-MPCRS can lead to a higher mortality among ICU and in-hospital patients.
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