ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Effect of fluid balance situation within 7 days and early fluid intake after admission to the intensive care unit on in-hospital mortality and one-year mortality in patients with cardiac arrest: a retrospective study from the MIMIC IV database
Provisionally accepted
- 1The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
- 2Harbin Medical University Cancer Hospital, Harbin, China
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Background: The objective of this study was to assess the associations between the mean daily fluid balance within 7 days and fluid intake within 24 hours after admission to intensive care unit (ICU) and mortality for hospitalization and one-year in cardiac arrest (CA) patients. Methods: Patients who experienced CA were enrolled from the Medical Information Mart for Intensive Care Database. CA patients were divided into <14 ml.kg-1, 14-37 ml.kg-1, 38-79 ml.kg-1 and >79 ml.kg-1 groups according to the interquartile range of the mean daily fluid balance. In addition, patients were divided into low (<147 ml.kg-1) fluid intake group and high (≥147 ml.kg-1) fluid intake group according to the median fluid intake within 24 hours after admission to the ICU. Multivariate logistic regression models were constructed to determine the independent risk factors for in-hospital mortality and one-year mortality. Results: The in-hospital mortality in the 38-79 ml.kg-1 and the >79 ml.kg-1 groups were higher than in the 14-37 ml.kg-1 and the <14 ml.kg-1 groups (P < 0.05). The one-year mortality in the 38-79 ml.kg-1 and the >79 ml.kg-1 groups were higher than in the <14 ml.kg-1 group (P < 0.05). The 38-79 ml.kg-1 and >79 ml.kg-1 groups were associated with increased risk of in-hospital mortality (odds ratio [OR] 2.300, 95% confidence interval [CI] 1.381-3.831; P = 0.001; OR 2.691, 95% CI 1.515-4.779; P = 0.001) and one-year mortality (OR 2.131, 95% CI 1.308-3.470; P = 0.002; OR 2.141, 95% CI 1.237-3.703; P = 0.006). The in-hospital mortality in the high-fluid intake group was higher than in the low-fluid intake group (P < 0.05). The one-year mortality was not significantly different between the two groups (P = 0.055). A high fluid intake was not associated with an increased risk of in-hospital mortality (OR 0.841, 95% CI 0.587-1.204; P = 0.344). Conclusions: Mean daily fluid balance ≥ 38 ml.kg-1 within 7 days after admission to the ICU was associated with increased in-hospital mortality and one-year mortality in cardiac arrest patients. Fluid intake ≥ 147 ml.kg-1 within 24 hours after admission to the ICU was not associated with increased in-hospital mortality in cardiac arrest patients.
Keywords: Cardiac arrest, Fluid resuscitation, Fluid balance, Intravenous fluid, Medical InformationMart for Intensive Care IV
Received: 01 Dec 2024; Accepted: 27 Oct 2025.
Copyright: © 2025 Zhang, Liu, Sui, Zhang, Xu, Sun, Yin and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fei Han, hanfeichina@hotmail.com
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