The impact of transthoracic echocardiography on the short-term prognosis of elderly patients in the intensive care unit: a retrospective analysis based on the MIMIC-III database

Li, Baoping; Shi, Dongwu; Zhu, Lili; Li, Ximei; Wang, Shuying; Yang, Feifei; Song, Yu Gil; Xue, Dan; Mao, Zhi

doi:10.21037/apm-21-1713

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Additionally, the maximum dose of norepinephrine in the TTE group was significantly higher than that in the non-TTE group. The results of this study were consistent with those of other studies (16,18). MODS mainly affects the heart, lungs, liver, and kidneys.…”

Section: Discussionsupporting

confidence: 93%

The relationship between transthoracic echocardiography and mortality in adult patients with multiple organ dysfunction syndrome: analysis of the MIMIC-III database

Fu¹,

Hu²,

Gong³

et al. 2022

Ann Transl Med

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Background: For patients with multiple organ dysfunction syndrome (MODS), timely assessment of the condition and real-time adjustment of the treatment plan are of critical importance. To this end, transthoracic echocardiography (TTE) is widely used in clinical practice, but whether TTE can improve the short-term prognosis of MODS patients is currently unclear.Methods: We extracted data of patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database and included cases according to inclusion and exclusion criteria. The primary endpoint was the mortality within 28 days after admission to the intensive care unit (ICU), and multivariate regression analysis was conducted to infer the risk factors associated death within 28 days after ICU admission. Double robust analysis was conducted to investigate the correlation between TTE and the endpoint. A gradient-boosted model (GBM) was constructed to calculate the propensity score (PS) of patients received TTE, so as to reduce the difference of variates between these two groups.Results: A total of 13,844 MODS cases were included and were divided into a TTE group and a non-TTE group. There were 5,022 cases (36.28%) in the TTE group, 2,416 (48.10%) of whom were female; and 8,822 (63.72%) in the non-TTE group, 4,129 of whom (46.80%) were female. The covariates that contributed significantly to PS included chronic heart failure (CHF), creatine kinase (CK), troponin, partial pressure of oxygen (PO 2 ), and sequential organ failure assessment (SOFA) scores. Double robust analysis showed that within 28 days after ICU admission, the TTE group had lower risk of death when compared with the non-TTE group. The adjusted odds ratio (OR) value of TTE for 28 days death was 0.73 [95% confidence interval (CI): 0.65-0.82; P<0.001]. The other 3 models had similar results, suggesting that conduct TTE for patients with MODS in ICU was associated with lower risk of 28 days mortality.Conclusions: TTE can reduce the mortality of MODS patients in the ICU.

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Section: Discussionsupporting

confidence: 93%

The relationship between transthoracic echocardiography and mortality in adult patients with multiple organ dysfunction syndrome: analysis of the MIMIC-III database

Fu¹,

Hu²,

Gong³

et al. 2022

Ann Transl Med

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“…The results of the present study of patients with AKI in the ICU are consistent with those of the study by Feng et al (11), who focused on sepsis patients in the ICU. Similarly, in another study, Li et al found that performing TTE was associated with decreased 28-day mortality in middleaged and elderly patients in the ICU (16). In fact, all three categories (AKI, sepsis, older) are common patients in ICUs, and there is extensive overlap between the categories (17,18).…”

Section: Discussionmentioning

confidence: 86%

“…Therefore, in the matched cohort, there may have been some patients who should have undergone TTE but did not and this can lead to the clinician not fully understanding the patient’s condition, which is not conducive to the formulation or adjustment of treatment plans. Based on the results of this and similar studies ( 11 , 16 ), for patients with clear indications for a TTE examination, it should be actively considered, and may help reduce the short-term risk of death of patients ( 11 , 20 , 21 ).…”

Section: Discussionmentioning

confidence: 91%

Effect of transthoracic echocardiography on short-term outcomes in patients with acute kidney injury in the intensive care unit: a retrospective cohort study based on the MIMIC-III database

Liu¹,

Wang²,

Wang³

2022

Ann Transl Med

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Background Acute kidney injury (AKI) is a common problem in the intensive care unit (ICU). Transthoracic echocardiography (TTE) has become a common test in the ICU. But the effect of TTE on the short-term prognosis in ICU patients with AKI remains unclear. We aimed to analyze the relationship between TTE and short-term prognosis in ICU patients with AKI. Methods AKI patients in the Medical Information Mart for Intensive Care (MIMIC)-III database were retrospectively enrolled according to inclusion and exclusion criteria, and their clinical information was extracted. TTE was conducted during ICU stay. AKI was diagnosed according to KIDGO criteria. The primary endpoint was the outcome of 28-day ICU stay. The doubly robust estimation method was used to analyze the association of TTE with the primary and secondary outcomes of patients with AKI in ICU. The gradient boosted model (GBM) was used to estimate the propensity score of patients to undergo TTE examination, thereby minimizing the variable imbalance between the TTE and non-TTE groups. Weighted cohorts were built using the inverse probabilities weighting (IPW) model with estimated propensity scores as weights. The weighted cohort was analyzed using logistic regression and validated using other models. Results A total of 2,983 patients were included. In the original cohort, 28-day mortality was 37.9% in the TTE group (n=1,684) and 40.8% in the non-TTE group (n=1,299). In the propensity score model (PSM) cohort, 28-day mortality was 34.6% in the TTE group (n=702) and 45.6% in the non-TTE group (n=702). Doubly robust analysis showed that TTE was associated with lower 28-day mortality. Conclusions TTE examination might decrease the 28-day mortality in patients with AKI in the ICU and should be considered for critical patients when necessary.

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Harnessing the Power of AI: A Comprehensive Review of Left Ventricular Ejection Fraction Assessment With Echocardiography

Barris,

Karp,

Jacobs

et al. 2024

Cardiology in Review

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The quantification of left ventricular ejection fraction (LVEF) has important clinical utility in the assessment of cardiac function and is vital for the diagnosis of cardiovascular diseases. A transthoracic echocardiogram serves as the most commonly used tool for LVEF assessment for several reasons, including, its noninvasive nature, great safety profile, real-time image processing ability, portability, and cost-effectiveness. However, transthoracic echocardiogram is highly dependent on the clinical skill of the sonographer and interpreting physician. Moreover, even amongst well-trained clinicians, significant interobserver variability exists in the quantification of LVEF. In search of possible solutions, the usage of artificial intelligence (AI) has been increasingly tested in the clinical setting. While AI-derived ejection fraction is in the preliminary stages of development, it has shown promise in its ability to rapidly quantify LVEF, decrease variability, increase accuracy, and utilize higher-order processing capabilities. This review will delineate the latest advancements of AI in evaluating LVEF through echocardiography and explore the challenges and future trajectory of this emerging domain.

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The impact of transthoracic echocardiography on the short-term prognosis of elderly patients in the intensive care unit: a retrospective analysis based on the MIMIC-III database

Cited by 3 publications

References 27 publications

The relationship between transthoracic echocardiography and mortality in adult patients with multiple organ dysfunction syndrome: analysis of the MIMIC-III database

The relationship between transthoracic echocardiography and mortality in adult patients with multiple organ dysfunction syndrome: analysis of the MIMIC-III database

Effect of transthoracic echocardiography on short-term outcomes in patients with acute kidney injury in the intensive care unit: a retrospective cohort study based on the MIMIC-III database

Harnessing the Power of AI: A Comprehensive Review of Left Ventricular Ejection Fraction Assessment With Echocardiography

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