Association between chest congestion and mortality in ICU patients

Purpose: Recent years have seen significant progress in hemodynamic monitoring and management. There has been an evolution from invasive to less invasive technologies. This study evaluated the relationship between chest congestion via thoracic fluid content (TFC) and mortality among critically ill patients in the Intensive Care Unit (ICU).
Methods: This retrospective case-control study assessed 373 patients admitted to the ICU of Taipei Veterans General Hospital from December 2012 to June 2013. In total, 149 individuals (n = 149) were excluded due to incomplete or missing information. Patients who died during the study interval were selected as the case group while the surviving participants represented the control group. The (TFC) thoracic fluid content was collected by an ICON Electrical Cardiometry device in all patients. Mortality odds ratios (ORs) and 95% confidence intervals (CI) were estimated using multiple logistic regression models.
Results: A total of 224 patients (84 who died in the ICU and 140 who remained alive) were included in the final analysis. The aOR for mortality was significantly higher in patients with abnormal or high TFC (≥50 kΩ−1) than in those with TFC <50 kΩ−1 (aOR, 2.278; 95% CI 1.1216-4.268). Results from the sex stratified analysis model showed that the aOR for mortality was significantly higher among men (aOR, 2.209; 95% CI, 1.006-4.848; P = 0.0482) but not women (aOR, 2.085; 95% CI, 0.631-6.890; P =0 .2284) with TFC≥50 kΩ−1 compared to TFC <50 kΩ−1.
Conclusions: In this study, high TFC was associated with a higher mortality rate in critically ill ICU patients. The mortality risk was more pronounced in male patients.