Association of pulmonary artery catheter use with in-hospital mortality

Bekele Afessa, Scott Spencer, Waseem Khan, Mark LaGatta, Lisa Bridges, Amado Freire

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. Design: Prospective, observational study. Setting: The medical intensive care units (MICU) of two teaching hospitals. Methods: The study included 751 adults who were admitted to the MICU, excluding those who stayed for <24 hrs. Demographics and the worst Acute Physiology and Chronic Health Evaluation (APACHE) II score within the first 24 hrs of MICU admission were obtained. Daily logistic organ dysfunction system (LODS) scores were calculated. The associations of in-hospital mortality with the admission source, admission disease category, APACHE II scores, the worst LODS scores, mechanical ventilation, and PAC use were determined using chi-square, Mann-Whitney U, and multiple logistic regression analysis tests. p Values < 0.05 were considered significant. Results: Mean patient age was 52.6 ± 17.1 yrs; 425 (57%) were male; 464 (62%) were African-American, 275 (37%) Caucasian, 6 (1%) Asian, and 6 (1%) Hispanic. PAC was used in 119/751 (16%). The median APACHE II and worst LODS scores were 19 and 4, respectively. The in-hospital mortality rate was 159/751 (21%). The median APACHE II score for survivors was 17.5, compared with 28.0 for nonsurvivors (p < .0001). The worst median LODS score was 4 for survivors, compared with 11 for nonsurvivors (p < .0001). Sixty-four (54%) of the 119 patients with PAC died, compared with 95 (15%) of the 632 without PAC (p < .0001). Multiple logistic regression analysis showed that higher APACHE II-predicted mortality rate (p = .0088) and worst daily LODS score (p < .0001) were associated with increased mortality. The admission source, admission disease category, PAC use, and mechanical ventilation were not associated with in-hospital mortality. Conclusions: This study could not detect an association between PAC use and mortality. The APACHE II-predicted mortality rate and the development of multiple organ dysfunction were the main determinants of poor outcome in critically ill patients admitted to MICU.

Original languageEnglish (US)
Pages (from-to)1145-1148
Number of pages4
JournalCritical Care Medicine
Volume29
Issue number6
DOIs
StatePublished - Jan 1 2001

Fingerprint

APACHE
Hospital Mortality
Organ Dysfunction Scores
Pulmonary Artery
Catheters
Intensive Care Units
Mortality
Artificial Respiration
Survivors
Logistic Models
Regression Analysis
Hispanic Americans
Critical Illness
Teaching Hospitals
African Americans
Observational Studies
Demography
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Association of pulmonary artery catheter use with in-hospital mortality. / Afessa, Bekele; Spencer, Scott; Khan, Waseem; LaGatta, Mark; Bridges, Lisa; Freire, Amado.

In: Critical Care Medicine, Vol. 29, No. 6, 01.01.2001, p. 1145-1148.

Research output: Contribution to journalArticle

Afessa, Bekele ; Spencer, Scott ; Khan, Waseem ; LaGatta, Mark ; Bridges, Lisa ; Freire, Amado. / Association of pulmonary artery catheter use with in-hospital mortality. In: Critical Care Medicine. 2001 ; Vol. 29, No. 6. pp. 1145-1148.
@article{61a8b9d55be84cf28d20341c99983609,
title = "Association of pulmonary artery catheter use with in-hospital mortality",
abstract = "Objective: To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. Design: Prospective, observational study. Setting: The medical intensive care units (MICU) of two teaching hospitals. Methods: The study included 751 adults who were admitted to the MICU, excluding those who stayed for <24 hrs. Demographics and the worst Acute Physiology and Chronic Health Evaluation (APACHE) II score within the first 24 hrs of MICU admission were obtained. Daily logistic organ dysfunction system (LODS) scores were calculated. The associations of in-hospital mortality with the admission source, admission disease category, APACHE II scores, the worst LODS scores, mechanical ventilation, and PAC use were determined using chi-square, Mann-Whitney U, and multiple logistic regression analysis tests. p Values < 0.05 were considered significant. Results: Mean patient age was 52.6 ± 17.1 yrs; 425 (57{\%}) were male; 464 (62{\%}) were African-American, 275 (37{\%}) Caucasian, 6 (1{\%}) Asian, and 6 (1{\%}) Hispanic. PAC was used in 119/751 (16{\%}). The median APACHE II and worst LODS scores were 19 and 4, respectively. The in-hospital mortality rate was 159/751 (21{\%}). The median APACHE II score for survivors was 17.5, compared with 28.0 for nonsurvivors (p < .0001). The worst median LODS score was 4 for survivors, compared with 11 for nonsurvivors (p < .0001). Sixty-four (54{\%}) of the 119 patients with PAC died, compared with 95 (15{\%}) of the 632 without PAC (p < .0001). Multiple logistic regression analysis showed that higher APACHE II-predicted mortality rate (p = .0088) and worst daily LODS score (p < .0001) were associated with increased mortality. The admission source, admission disease category, PAC use, and mechanical ventilation were not associated with in-hospital mortality. Conclusions: This study could not detect an association between PAC use and mortality. The APACHE II-predicted mortality rate and the development of multiple organ dysfunction were the main determinants of poor outcome in critically ill patients admitted to MICU.",
author = "Bekele Afessa and Scott Spencer and Waseem Khan and Mark LaGatta and Lisa Bridges and Amado Freire",
year = "2001",
month = "1",
day = "1",
doi = "10.1097/00003246-200106000-00010",
language = "English (US)",
volume = "29",
pages = "1145--1148",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Association of pulmonary artery catheter use with in-hospital mortality

AU - Afessa, Bekele

AU - Spencer, Scott

AU - Khan, Waseem

AU - LaGatta, Mark

AU - Bridges, Lisa

AU - Freire, Amado

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Objective: To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. Design: Prospective, observational study. Setting: The medical intensive care units (MICU) of two teaching hospitals. Methods: The study included 751 adults who were admitted to the MICU, excluding those who stayed for <24 hrs. Demographics and the worst Acute Physiology and Chronic Health Evaluation (APACHE) II score within the first 24 hrs of MICU admission were obtained. Daily logistic organ dysfunction system (LODS) scores were calculated. The associations of in-hospital mortality with the admission source, admission disease category, APACHE II scores, the worst LODS scores, mechanical ventilation, and PAC use were determined using chi-square, Mann-Whitney U, and multiple logistic regression analysis tests. p Values < 0.05 were considered significant. Results: Mean patient age was 52.6 ± 17.1 yrs; 425 (57%) were male; 464 (62%) were African-American, 275 (37%) Caucasian, 6 (1%) Asian, and 6 (1%) Hispanic. PAC was used in 119/751 (16%). The median APACHE II and worst LODS scores were 19 and 4, respectively. The in-hospital mortality rate was 159/751 (21%). The median APACHE II score for survivors was 17.5, compared with 28.0 for nonsurvivors (p < .0001). The worst median LODS score was 4 for survivors, compared with 11 for nonsurvivors (p < .0001). Sixty-four (54%) of the 119 patients with PAC died, compared with 95 (15%) of the 632 without PAC (p < .0001). Multiple logistic regression analysis showed that higher APACHE II-predicted mortality rate (p = .0088) and worst daily LODS score (p < .0001) were associated with increased mortality. The admission source, admission disease category, PAC use, and mechanical ventilation were not associated with in-hospital mortality. Conclusions: This study could not detect an association between PAC use and mortality. The APACHE II-predicted mortality rate and the development of multiple organ dysfunction were the main determinants of poor outcome in critically ill patients admitted to MICU.

AB - Objective: To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. Design: Prospective, observational study. Setting: The medical intensive care units (MICU) of two teaching hospitals. Methods: The study included 751 adults who were admitted to the MICU, excluding those who stayed for <24 hrs. Demographics and the worst Acute Physiology and Chronic Health Evaluation (APACHE) II score within the first 24 hrs of MICU admission were obtained. Daily logistic organ dysfunction system (LODS) scores were calculated. The associations of in-hospital mortality with the admission source, admission disease category, APACHE II scores, the worst LODS scores, mechanical ventilation, and PAC use were determined using chi-square, Mann-Whitney U, and multiple logistic regression analysis tests. p Values < 0.05 were considered significant. Results: Mean patient age was 52.6 ± 17.1 yrs; 425 (57%) were male; 464 (62%) were African-American, 275 (37%) Caucasian, 6 (1%) Asian, and 6 (1%) Hispanic. PAC was used in 119/751 (16%). The median APACHE II and worst LODS scores were 19 and 4, respectively. The in-hospital mortality rate was 159/751 (21%). The median APACHE II score for survivors was 17.5, compared with 28.0 for nonsurvivors (p < .0001). The worst median LODS score was 4 for survivors, compared with 11 for nonsurvivors (p < .0001). Sixty-four (54%) of the 119 patients with PAC died, compared with 95 (15%) of the 632 without PAC (p < .0001). Multiple logistic regression analysis showed that higher APACHE II-predicted mortality rate (p = .0088) and worst daily LODS score (p < .0001) were associated with increased mortality. The admission source, admission disease category, PAC use, and mechanical ventilation were not associated with in-hospital mortality. Conclusions: This study could not detect an association between PAC use and mortality. The APACHE II-predicted mortality rate and the development of multiple organ dysfunction were the main determinants of poor outcome in critically ill patients admitted to MICU.

UR - http://www.scopus.com/inward/record.url?scp=0034987736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034987736&partnerID=8YFLogxK

U2 - 10.1097/00003246-200106000-00010

DO - 10.1097/00003246-200106000-00010

M3 - Article

VL - 29

SP - 1145

EP - 1148

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 6

ER -