ArticleRespiratory research2024
Identifying vital sign trajectories to predict 28-day mortality of critically ill elderly patients with acute respiratory distress syndrome.
Article in Respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 5 citations in OpenAlex.
- C-reactive protein-triglyceride glucose index and its dynamic trajectories on all-cause mortality in critically ill children: a longitudinal, retrospective cohort study.Pediatric research · 2026Article
- Prognostic significance of the endothelial activation and stress index in acute respiratory distress syndrome: a retrospective cohort study.Scientific reports · 2026Article
- Dynamic Parameters within the First 72 H of ICU Admission Predict Extubation Failure and 28-Day Mortality in Severe Pneumonia-Induced ARDS: A Retrospective Cohort Study.The clinical respiratory journal · 2026Article
- Stratifying mortality risk in hypotension using outcome-oriented clustering of vital sign trajectories.iScience · 2026Article
- Article
- Development and validation of a prognostic model for acute respiratory distress syndrome in critically Ill patients with intra-abdominal sepsis: a multicenter cohort study.Frontiers in medicine · 2026Article
- A prediction model for 30-day mortality in patients with ARDS admitted to the intensive care unit.European journal of medical research · 2025Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe mortality rate of acute respiratory distress syndrome (ARDS) increases with age (≥ 65 years old) in critically ill patients, and it is necessary to prevent mortality in elderly patients with ARDS in the intensive care unit (ICU). Among the potential risk factors, dynamic subphenotypes of respiratory rate (RR), heart rate (HR), and respiratory rate-oxygenation (ROX) and their associations with 28-day mortality have not been clearly explored.
methodsBased on the eICU Collaborative Research Database (eICU-CRD), this study used a group-based trajectory model to identify longitudinal subphenotypes of RR, HR, and ROX during the first 72 h of ICU stays. A logistic model was used to evaluate the associations of trajectories with 28-day mortality considering the group with the lowest rate of mortality as a reference. Restricted cubic spline was used to quantify linear and nonlinear effects of static RR-related factors during the first 72 h of ICU stays on 28-day mortality. Receiver operating characteristic (ROC) curves were used to assess the prediction models with the Delong test.
resultsA total of 938 critically ill elderly patients with ARDS were involved with five and 5 trajectories of RR and HR, respectively. A total of 204 patients fit 4 ROX trajectories. In the subphenotypes of RR, when compared with group 4, the odds ratios (ORs) and 95% confidence intervals (CIs) of group 3 were 2.74 (1.48-5.07) (P = 0.001). Regarding the HR subphenotypes, in comparison to group 1, the ORs and 95% CIs were 2.20 (1.19-4.08) (P = 0.012) for group 2, 2.70 (1.40-5.23) (P = 0.003) for group 3, 2.16 (1.04-4.49) (P = 0.040) for group 5. Low last ROX had a higher mortality risk (P linear = 0.023, P nonlinear = 0.010). Trajectories of RR and HR improved the predictive ability for 28-day mortality (AUC increased by 2.5%, P = 0.020).
conclusionsFor RR and HR, longitudinal subphenotypes are risk factors for 28-day mortality and have additional predictive enrichment, whereas the last ROX during the first 72 h of ICU stays is associated with 28-day mortality. These findings indicate that maintaining the health dynamic subphenotypes of RR and HR in the ICU and elevating static ROX after initial critical care may have potentially beneficial effects on prognosis in critically ill elderly patients with ARDS.
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