Association between estimated pulse wave velocity and in-hospital mortality of patients with acute kidney injury: a retrospective cohort analysis of the MIMIC-IV database

Xinhai Cui; Yuanlong Hu; Dongxiao Li; Mengkai Lu; Zhiyuan Zhang; Dongfang Kan; Chao Li

doi:10.1080/0886022X.2024.2313172

Association between estimated pulse wave velocity and in-hospital mortality of patients with acute kidney injury: a retrospective cohort analysis of the MIMIC-IV database

Ren Fail. 2024 Dec;46(1):2313172. doi: 10.1080/0886022X.2024.2313172. Epub 2024 Feb 15.

Authors

Xinhai Cui¹, Yuanlong Hu², Dongxiao Li³, Mengkai Lu³, Zhiyuan Zhang³, Dongfang Kan³, Chao Li³

Affiliations

¹ College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
² First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
³ Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.

Abstract

Background: Estimated pulse wave velocity (ePWV) has been found to be an independent predictor of cardiovascular mortality and kidney injury, which can be estimated noninvasively. This study aimed to investigate the association between ePWV and in-hospital mortality in critically ill patients with acute kidney injury (AKI).

Methods: This study included 5960 patients with AKI from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The low and high ePWV groups were compared using a Kaplan-Meier survival curve to evaluate the differences in survival status. Cox proportional hazards models were used to explore the association between ePWV and in-hospital mortality in critically ill patients with AKI. To further examine the dose-response relationship, we used a restricted cubic spline (RCS) model. Stratification analyses were conducted to investigate the effect of ePWV on hospital mortality across various subgroups.

Results: Survival analysis indicated that patients with high ePWV had a lower survival rate than those with low ePWV. Following adjustment, high ePWV demonstrated a statistically significant association with an increased risk of in-hospital mortality among AKI patients (HR = 1.53, 95% CI = 1.36-1.71, p < 0.001). Analysis using the RCS model confirmed a linear increase in the risk of hospital mortality as the ePWV values increased (P for nonlinearity = 0.602).

Conclusions: A high ePWV was significantly associated with an increased risk of in-hospital mortality among patients with AKI. Furthermore, ePWV was an independent predictor of in-hospital mortality in critically ill patients with AKI.

Keywords: Acute kidney injury; MIMIC-IV database; estimated pulse wave velocity; in-hospital mortality.

MeSH terms

Acute Kidney Injury*
Critical Care
Critical Illness
Hospital Mortality
Humans
Pulse Wave Analysis*
Retrospective Studies

Grants and funding

This research was supported by National Nature Science Foundation of China (No. 82004276), Natural Science Foundation of Shandong Province (No. ZR2020QH305), Joint Fund Project of Natural Science Foundation of Shandong Province (No. ZR2021LZY022), and Shandong Provincial Medical and Health Science and Technology Development Program (No. 2019WS552). In addition, we would like to acknowledge the conference where an earlier version of this work was presented in the form of an abstract. We extend our gratitude to the ‘The 34th Great Wall International Congress of Cardiology Asian Heart Society Congress 2023’ held at Beijing, China on 7 September 2023. The abstract was made available online through ‘Cardiovascular Innovations and Applications 2023;8(s1):C1-C207’ and can be accessed via the following link: https://www.scienceopen.com/hosted-document? doi = 10.15212%2FCVIA.2023.0059.