{"title":"时间加权平均机械功率标准化与危重患者依从性与预后之间的关系：基于MIMIC-IV数据库的回顾性队列研究","authors":"Yukang Dong, Guiyun Li, Jiangquan Fu, Rui Huang, Huan Yao, Jingni Wang, Ying Wang, Feng Shen","doi":"10.1016/j.medine.2025.502258","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MP<sub>CRS</sub>) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Intensive care unit (ICU).</p><p><strong>Patients or participants: </strong>4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>TWA-MP<sub>CRS</sub>, ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MP<sub>CRS</sub> was 0.3 (0.2, 0.6) J/min/mL/cmH<sub>2</sub>O. When TWA-MP<sub>CRS</sub> 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.</p><p><strong>Conclusion: </strong>Higher TWA-MP<sub>CRS</sub> is associated with poor clinical outcomes in critically ill patients. Higher TWA-MP<sub>CRS</sub> can lead to a higher mortality among ICU and in-hospital patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502258"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Yukang Dong, Guiyun Li, Jiangquan Fu, Rui Huang, Huan Yao, Jingni Wang, Ying Wang, Feng Shen\",\"doi\":\"10.1016/j.medine.2025.502258\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MP<sub>CRS</sub>) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Intensive care unit (ICU).</p><p><strong>Patients or participants: </strong>4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>TWA-MP<sub>CRS</sub>, ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MP<sub>CRS</sub> was 0.3 (0.2, 0.6) J/min/mL/cmH<sub>2</sub>O. When TWA-MP<sub>CRS</sub> 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.</p><p><strong>Conclusion: </strong>Higher TWA-MP<sub>CRS</sub> is associated with poor clinical outcomes in critically ill patients. Higher TWA-MP<sub>CRS</sub> can lead to a higher mortality among ICU and in-hospital patients.</p>\",\"PeriodicalId\":94139,\"journal\":{\"name\":\"Medicina intensiva\",\"volume\":\" \",\"pages\":\"502258\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina intensiva\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.medine.2025.502258\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina intensiva","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.medine.2025.502258","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.
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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