Heart failure & cardiomyopathies
Hypocapnia is an Independent Predictor of in-Hospital Mortality in Acute Heart Failure
Authors' conclusion
Hypocapnia is an independent predictor of in-hospital mortality for AHF.
Study context
- Population
- Patients treated in the coronary care unit for acute HFmatched cohort 264 per group
- Participants
- 676 patients
- Exposure
- Hypocapnia vs no hypocapnia on admission
- Outcome
- In-hospital all-cause mortality
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Before PSM
P < 0.001
After PSM
P < 0.001
- Hypocapnia as independent predictor of mortality, multivariate Cox, before propensity score matching (PSM): HR 2.22 (95% CI 1.23-3.98)
- P = 0.008
- Hypocapnia as independent predictor of mortality, multivariate Cox, after PSM: HR 2.19 (95% CI 1.18-4.07)
- P = 0.013
- Higher probability of in-hospital death with hypocapnia before and after PSM (Kaplan-Meier, log-rank)
- both P < 0.001
Observational data: associations, not effects.
Further findings
Hypocapnia in non-survivors vs survivors
P < 0.001
| Outcome | AUC (95% CI) | P value |
|---|---|---|
| AUC of mortality model with vs without hypocapniavs 0.855 (95% CI 0.820-0.886); Delong's test | 0.872 (0.839–0.901) | P = 0.028 |
- Hypocapnia in non-survivors vs survivors — In-hospital deaths
- 98 (14.5%)
- Hypocapnia in non-survivors vs survivors: 98 = patients who died
Correlations of PaCO2
- eGFR
- r = 0.20, P = 0.001
- LVEF
- r = 0.13, P < 0.001
- B-type natriuretic peptide
- r = −0.28, P < 0.001
- Lactate
- r = −0.15, P < 0.001
In-hospital mortality by PaCO2 tertiles
- Lowest PaCO2 tertile associated with increased risk of in-hospital mortality
- all P < 0.05
Original publication
Hypocapnia is an Independent Predictor of in-Hospital Mortality in Acute Heart Failure. ESC Heart Fail. Published 6 February 2023. doi:10.
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