Baseline characteristics and outcomes of patients admitted to intensive cardiovascular care unit
Authors: Juzar D A , Bagaswoto H P , Muzakkir A F , Habib F , Astiawati T , Prasetya I , Wirawan H , Rizal Y , Djafar D U , Sungkar S , Danny S S 
Published: October 2024

Abstract

Background
Intensive Cardiovascular Care Unit (ICCU) is a crucial element of care for critically ill patients suffering from cardiovascular disease. Therefore, we aimed to provide data on the characteristics and outcomes of patients admitted to ICCU.

Methods
Data was obtained from One Intensive Cardiovascular Care Unit (One ICCU) Registry, a collaborative multicentre research network of ICCU. A total of 10 centres participated in this registry, eight centres were ICCU level III and the remaining were ICCU level II. Each participating centre collected data of patients admitted to ICCU from August 2021 until August 2023. Data recorded were demographics, past medical history, diagnosis, treatment, complications, outcome, and 30-day follow up. Only first ICCU admission data from each patient was analysed to prevent outcome-related bias from readmission data.

Results
12,950 patients were included in the analysis of which 9308 (71.9%) were male and the median age was 59 (51-66) years. Most common diagnosis on admission was acute coronary syndromes (69.8%) followed by acute heart failure (34.6%) and arrhythmias (25.8%). Cardiovascular complication most frequently during ICCU stay was cardiogenic shock (18.9%) while for non-cardiovascular complication was acute kidney injury (17.4%). Cardiac arrest (61.2%), respiratory failure (43%), and sepsis (38%) were among the highest case fatality rates for ICCU complications. Overall mortality was found to be approximately 11.4%, 14.3%, and 15.2% for intra ICCU, in-hospital and 30-day mortality, respectively. Non-cardiovascular variables which were independently associated with 30-day mortality were pre-existing asthma (OR 2.12, CI 1.315 – 3.411, p=0.002) and chronic kidney disease (OR 1.67, CI 1.308 – 2.139, p&lt;0.001), initial diagnosis of respiratory failure (OR 4.01, CI 3.373 – 4.773, p&lt;0.001), haemorrhagic stroke(OR 3.46, CI 1.396 – 8.574, p=0.007), ischaemic stroke (OR 3.12, CI 2.248 – 4.345, p&lt;0.001), sepsis (OR 2.00, CI 1.715 – 2.334, p&lt;0.001), urinary tract infection (OR 1.60, CI 1.228 – 2.226, p=0.001) and pneumonia (OR 1.29, CI 1.120 – 1.482, p&lt;0.001), as well as complications during ICCU stay which consisted of haemorrhagic stroke (OR 3.91, CI 1.062 – 14.414, p=0.040), respiratory failure (OR 2.91, CI 2.081 – 4.070, p&lt;0.001), sepsis (OR 2.17, CI 1.686 – 2.790, p&lt;0.001), ischaemic stroke (OR 1.84, CI 1.074 – 3.139, p=0.026), and urinary tract infection (OR 1.39, CI 1.039 – 1.851, p=0.026).

Conclusion
Patients admitted to our ICCU were relatively younger and the cause for ICCU admission was still predominated by acute coronary syndrome. Despite that, non-cardiovascular condition also warrants clinicians attention due to its significant role as predictors of mortality. Non-cardiac complications that arise during ICCU care also emphasize the importance of collaboration with specialists in other disciplines to improve patient’s outcomes.Diagnosis (A) and Case Fatality (B)Mortality Predictors at 30 days