Impact of mechanical ventilation on clinical outcomes in ICU-admitted Alzheimer's disease patients: a retrospective cohort study

• Published in: Frontiers in public health 2024-03, Vol.12, p.1368508-1368508
• Main Authors: Liu, Han, Liang, Qun, Yang, Yang, Liu, Min, Zheng, Boyang, Sun, Shilin
• Format: Article
• Language: English
• Subjects: Alzheimer Disease - therapy; Alzheimer’s disease; Critical Care - methods; Humans; ICU; Intensive Care Units; management strategies; mechanical ventilation; MIMIC-IV; mortality; Public Health; Respiration, Artificial; Retrospective Studies
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2024.1368508

Alzheimer's disease (AD) is increasingly recognized as a pressing global public health issue, demanding urgent development of scientific AD management strategies. In recent years, the proportion of AD patients in Intensive Care Units (ICU) has been on the rise. Simultaneously, the use of mechanical ventilation (MV) is becoming more prevalent among this specific patient group. Considering the pathophysiological characteristics of AD, the application of MV in AD patients may lead to different outcomes. However, due to insufficient research data, the significant impact of MV on the prognosis of AD patients in the ICU remains unclear. Therefore, we conducted this study to comprehensively evaluate the potential influence of MV on the survival rate of AD patients in the ICU. We obtained data from the MIMIC-IV database for patients diagnosed with AD. Using propensity score matching (PSM), we paired patients who received MV treatment with those who did not receive treatment. Next, we conducted Cox regression analysis to evaluate the association between MV and in-hospital mortality, 7-day mortality, 28-day mortality, 90-day mortality, 4-year mortality, length of hospital stay, and ICU stay. The data analysis involved a cohort of 641 AD patients spanning from 2008 to 2019, inclusive. Following a 1:2 propensity score matching (PSM) procedure, 300 patients were successfully paired, comprising 123 individuals who underwent MV treatment and 177 who did not. MV demonstrated an association with an elevated risk of in-hospital mortality (HR 5.782; 95% CI 2.981-11.216;