Association of estimated pulse wave velocity with risk of in-hospital mortality in patients with sepsis: a study based on Medical Information Mart for Intensive Care database

This study analyzed the association between estimated pulse wave velocity (ePWV) and the risk of hospital mortality in sepsis patients in the intensive care unit (ICU). Utilizing a retrospective cohort study design, this investigation extracted data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Participants were categorized into groups based on the median ePWV values. The primary outcome measured was in-hospital mortality among patients within the ICU. To delve into the relationship between ePWV and the risk of in-hospital mortality in sepsis patients admitted to the ICU, the study employed univariate and multivariate Cox proportional hazards regression models. Additionally, subgroup analyses were performed, stratifying the data by age, gender, and the presence of comorbid conditions to further elucidate the findings. A total of 11, 069 were included in the analysis, with 1,568 (14.2%) experiencing in-hospital mortality. When analyzed as a continuous variable, each 1 m/s increase in ePWV was associated with a 10% increase in the risk of in-hospital mortality [hazard ratio (HR): 1.10, 95% confidence interval (CI): 1.06–1.14, P < 0.001]. In the analysis dichotomized at the median (9.73 m/s), patients with higher ePWV (≥ 9.73 m/s) also had a significantly increased risk (adjusted HR: 1.25, 95% CI: 1.08–1.44, P = 0.002]. Upon conducting subgroup analyses, a consistent trend was identified where increased ePWV was associated with a higher risk of in-hospital mortality across different patient demographics, including various age groups and genders, and in individuals with acute myocardial infarction and hypertensive diseases. However, the association between ePWV and in-hospital mortality was significant only in sepsis patients without heart failure. The study’s results demonstrate a significant association between elevated ePWV levels and an increased risk of in-hospital mortality among individuals with sepsis. By identifying patients with higher ePWV levels, healthcare providers may be able to implement more targeted risk assessment strategies and tailor therapeutic approaches to improve patient outcomes.