Abstract 101: Association Of Cardiovascular Disorder Requiring Intubation To In-hospital Mortality And Discharge Status Of The Patients: Analysis Of 17,128 Hospitalizations
Introduction: Endotracheal intubations are a vital cornerstone of care for critically ill patients. The decision to intubate a critically ill patient is often complicated secondary to long term prognosis of underlying illness and extent of aggressive treatment a patient would desire. This study was done to identify association of cardiovascular disorder requiring endotracheal intubation to in-hospital mortality and discharge status of the patients.
Methods: Nationwide Inpatient Sample data (which represents 20% of all the hospitals data in US) was used for the study and data related to all the intubations for the year 2011 was extracted. Patients with complete data on endotracheal intubations associated with primary cardiovascular diagnosis of acute myocardial infarction (MI), cardiac arrest and ventricular fibrillation (CA/VFib), congestive heart failure (CHF), acute cerebrovascular accident (CVA) and cardiac dysrhythmia were included in the study. Statistical analysis was done using SPSS.
Results: A total of 17,128 intubations associated with primary cardiovascular diagnosis were identified. In-hospital mortality for endotracheal intubations secondary to cardiovascular etiology was significantly higher than intubations secondary to non-cardiovascular etiology (58.5 % vs 29.43%, p value <0.001). CA/VFib (84.39%), MI (61.74%) and CVA (60.67%) were associated with significantly higher in-hospital mortality than cardiac dysrhythmia (49.44%) and CHF (42.11%) (p value <0.001). Patients with CHF were associated with significantly higher routine discharges (15.33%) or transfer to another short term hospital (12.53%) and patients with CVA were associated with discharge to another health care institution (23.42%) (p value <0.001).
Conclusions: Our study reports that patients who are intubated secondary to cardiovascular etiology have higher in-hospital mortality. Among these patients, patients having cardiac arrest/ventricular fibrillation have high in-hospital mortality and patients with CHF have higher routine discharges. This data can help clinicians to have well informed discussion with the family and weigh the risk and benefits of aggressively treating certain populations of critically ill cardiac patients with endotracheal intubation.
Author Disclosures: S. Aggarwal: None. A. Attaway: None. V. Gupta: None.
- © 2014 by American Heart Association, Inc.