Estimated plasma volume status (ePVS) is a predictor for acute myocardial infarction in-hospital mortality: analysis based on MIMIC-III database

Abstract

Background Estimated plasma volume status (ePVS) has been reported that associated with poor prognosis in heart failure patients. However, no researchinvestigated the association of ePVS and prognosis in patients with acute myocardial infarction (AMI). Therefore, we aimed to determine the association between ePVS and in-hospital mortality in AMI patients. Methods and results We extracted AMI patients data from MIMIC-III database. A generalized additive model and logistic regression model were used to demonstrate the association between ePVS levels and in-hospital mortality in AMI patients. Kaplan–Meier survival analysis was used to pooled the in-hospital mortality between the various group. ROC curve analysis were used to assessed the discrimination of ePVS for predicting in-hospital mortality. 1534 eligible subjects (1004 males and 530 females) with an average age of 67.36 ± 0.36 years old were included in our study finally. 136 patients (73 males and 63 females) died in hospital, with the prevalence of in-hospital mortality was 8.9%. The result of the Kaplan–Meier analysis showed that the high-ePVS group (ePVS ≥ 5.28 mL/g) had significant lower survival possibility in-hospital admission compared with the low-ePVS group (ePVS < 5.28 mL/g). In the unadjusted model, high-level of ePVS was associated with higher OR (1.09; 95% CI 1.06–1.12; P < 0.001) compared with low-level of ePVS. After adjusted the vital signs data, laboratory data, and treatment, high-level of ePVS were also associated with increased OR of in-hospital mortality, 1.06 (95% CI 1.03–1.09; P < 0.001), 1.05 (95% CI 1.01–1.08; P = 0.009), 1.04 (95% CI 1.01–1.07; P = 0.023), respectively. The ROC curve indicated that ePVS has acceptable discrimination for predicting in-hospital mortality. The AUC value was found to be 0.667 (95% CI 0.653–0.681). Conclusion Higher ePVS values, calculated simply from Duarte’s formula (based on hemoglobin/hematocrit) was associated with poor prognosis in AMI patients. EPVS is a predictor for predicting in-hospital mortality of AMI, and could help refine risk stratification.

Estimated plasma volume status as a simple and accessible predictor of 28-day mortality in septic shock: insights from a retrospective study of the MIMIC-IV database

“…Our cutoff value was set at 6.52 dL/g. This is an intriguing result, as in patients with acute myocardial infarction, an ePVS ≥5.28 mL/g emerged as a risk factor for in-hospital mortality and was associated with an elevated risk of 30-day mortality ( 23 ). However, in the report by Kim et al ( 24 ), they investigated ICU patients with sepsis or septic shock.…”

Association between estimated plasma volume status and acute kidney injury in patients who underwent coronary revascularization: A retrospective cohort study from the MIMIC-IV database

“…Previous researches have indicated that ePVS was a potential prognostic indicator associated with rehospitalization, and mortality in patients with AMI and HF [ 23 – 30 ]. Chen et al [ 24 ] reported that higher ePVS value was associated with a higher risk of in-hospital mortality in acute AMI patients. Soetjoadi et al [ 27 ] found that high ePVS was associated with in-hospital mortality in right HF.…”

Prediction of unplanned 30-day readmission for ICU patients with heart failure

“…The proposed approach had some limitations. Even though MIMIC-III is a comprehensive database and many recent research projects have been using the same database for their experiments [ 21 , 44 ], the data is almost 18 years old. Thus, we suggest that a newer multihospital database such as the Nationwide Readmission Database (NRD) [ 23 , 45 ] should be used in the future to externally validate our proposed model and its results.…”