Heart failure & cardiomyopathies
Hypocapnia is Associated with Increased In-Hospital Mortality and 1 Year Mortality in Acute Heart Failure Patients
Authors' conclusion
In AHF patients, hypocapnia within 24 h after admission to the ICU was associated with increased in-hospital mortality and 1 year mortality. However, the increase in 1 year mortality may be influenced by hospitalization mortality. Hypercapnia was associated with increased in-hospital mortality.
Study context
- Population
- Patients with acute heart failure admitted to the intensive care unit (ICU)
- Participants
- 2,374 patients
- Exposure
- PaCO2 <35 or >45 mmHg vs 35-45 mmHg within 24 h of ICU admission
- PaCO2 < 35 mmHgn = 457
- PaCO2 = 35-45 mmHgn = 1,072reference
- PaCO2 > 45 mmHgn = 845
- Outcome
- In-hospital mortality and 1 year mortality
Methodological detailsMIMIC-IV database
- MIMIC-IV database
Main finding
As reported in the abstract
PaCO2 < 35 mmHg
- In-hospital mortality
- 19.5%
- 1 year mortality
- 23.9%
PaCO2 < 35 mmHg
In-hospital mortality19.5%
1 year mortality23.9%
Each group vs PaCO2 = 35-45 mmHgHazard ratio (95% CI)P value
PaCO2 < 35 mmHgin-hospital mortality
1.398(1.039–1.882)
P = 0.027PaCO2 < 35 mmHg1 year mortality
1.327(1.020–1.728)
P = 0.035PaCO2 > 45 mmHgin-hospital mortality
1.387(1.050–1.832)
P = 0.021PaCO2 > 45 mmHg1 year mortality; no significant difference
1.286(0.995–1.662)
P = 0.055Observational data: associations, not effects.
Secondary outcomes
- Prediction of mortality by PaCO2 < 35 mmHg (AUC)
- 0.591 (95% CI 0.526-0.656) · AUC in-hospital mortality · AUC 1 year mortality 0.566 (95% CI 0.505-0.627)
Original publication
Hypocapnia is Associated with Increased In-Hospital Mortality and 1 Year Mortality in Acute Heart Failure Patients. ESC Heart Fail. Published 11 April 2024. doi:10.
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