Cardiovascular medication and long-term outcome among intensive care unit survivors: a retrospective study.

Abstract

We aimed to investigate the association between cardiovascular medications prescribed at ICU discharge and 1-year mortality in intensive care unit (ICU) survivors. This retrospective observational study was conducted at a single tertiary academic hospital. The study population comprised adult patients (aged ≥18 years) who were admitted to the general ICU between January 2012 and December 2016, survived, and were discharged. "Cardiovascular medication of ICU survivors" was defined as cardiovascular medications prescribed to ICU survivors for continued use after ICU discharge. Patients who had any cardiovascular medication prescribed at ICU discharge were classified as the CV MED group (n=10,777); all other patients comprised the non-CV MED group (n=7,288). A total of 18,065 ICU survivors participated in this study. After propensity score (PS) matching, a total of 8,456 patients (4,228 patients per group) were included in the analysis. In a Cox regression model, overall 1-year mortality after ICU discharge was 25% lower in the CV MED group, compared to the non-CV MED group (HR: 0.75, 95% CI: 0.66 to 0.84; P<0.001). In competing risk analysis, cancer-related 1-year mortality was 26% lower in the CV MED group (HR: 0.74, 95% CI: 0.62 to 0.89; P=0.001). The present study revealed associations of various cardiovascular medications at ICU discharge with decreases in 1-year overall mortality among ICU survivors. This association was more evident for cancer-related 1-year mortality. Our result suggested that with proper indication, cardiovascular medications might have beneficial long-term outcomes among ICU survivors.