Impact of central venous pressure measurement on the prognosis of patients with septic shock: A retrospective analysis of the MIMIC- IV database

Abstract

Objective: To assess the impact of measuring central venous pressure (CVP) on the prognosis of patients with septic shock. Methods: Septic shock patients with and without CVP measurements were identified in the Medical Information Mart for Intensive Care IV database. The primary outcome was 28-day mortality, and a multivariate logistic regression model was used to analyze the association between CVP measurement and 28-day mortality in patients with septic shock. The results were validated using logistic regression after propensity score matching. Secondary outcomes were in-hospital mortality, 1-year mortality, incidence of acute kidney injury within the first 7 days in the intensive care unit (ICU), and length of stay in the ICU. After propensity score matching, logistic regression analysis was conducted to analyze the correlation between CVP measurements and secondary outcomes in patients with septic shock. Results: A total of 2966 patients were included, including 1219 patients whose CVP was measured within 24h after admission to the ICU. CVP measurement was found to be not correlated with 28-day mortality (odds ratio=0.978, 95% Confidence Interval 0.798-1.200, P=0.835). Analyzing the cohort after propensity score matching, CVP measurement was found to be associated with prolonged ICU stay (4.9 vs. 3.2 days; P<0.001). No statistical differences were found in the primary outcome and other secondary outcomes between those with CVP measurement and those not. Conclusion: CVP measurement is associated with prolonged ICU stay in patients with septic shock but not associated with mortality and incidence of acute kidney injury within 7 days.