The following is a summary of “Association between estimated pulse wave velocity and the risk of mortality in patients with subarachnoid hemorrhage: a retrospective cohort study based on the MIMIC database,” published in the October 2024 issue of Neurology by Chen et al.
Estimated pulse wave velocity (ePWV) is a simple tool for measuring arterial stiffness and predicting long-term cardiovascular mortality. However, the association with mortality risk in patients with subarachnoid hemorrhage (SAH) remains unclear.
Researchers conducted a retrospective study evaluating the predictive value of ePWV on short- and long-term mortality in patients with SAH.
They extracted data from the Medical Information Mart for Intensive Care (MIMIC) III and IV databases, including adult patients with non-traumatic SAH. Weighted univariate and multivariable Cox regression analyses assessed the association between ePWV levels and 30-day mortality and 1-year mortality, reporting HRs and 95% CIs. Subgroup analyses were also performed based on age, Sequential Organ Failure Assessment (SOFA) score, surgery status, atrial fibrillation (AF), renal failure (RF), hepatic diseases, chronic obstructive pulmonary disease (COPD), sepsis, hypertension, and diabetes mellitus (DM).
The results showed 1,481 patients, 339 died within 30 days, and 435 died within 1 year. After adjusting for covariates, ePWV levels ≥12.10 were linked with a high risk of both 30-day mortality (HR = 1.77, 95% CI: 1.17–2.67) and 1-year mortality (HR = 1.97, 95% CI: 1.36–2.85) compared to ePWV levels <10.12. The area under the curve (AUC) for ePWV combined with the SOFA score demonstrated superior predictive performance for 30-day mortality (AUC = 0.740 vs. 0.664) and for 1-year mortality (AUC = 0.754 vs. 0.658). This positive relationship between ePWV and mortality risk was consistent across subgroups, including those aged ≥65 years, SOFA score <2, non-surgery, non-hepatic diseases, non-COPD, non-hypertension, non-DM, and sepsis.
They concluded that baseline ePWV levels may have predictive value for short- and long-term mortality in patients with SAH. However, further research is needed to clarify the application in SAH prognosis.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03897-5
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