Effects of Transthoracic Echocardiography on the Prognosis of Patients with Acute Respiratory Distress Syndrome: a Propensity Score Matched Analysis of the MIMIC-III Database

Introduction: Acute respiratory distress syndrome (ARDS) has high mortality and is mainly related to the circulatory failure.Therefore, real-time monitoring of cardiac function and structural changes has important clinical significance.Transthoracic echocardiography (TTE) is a simple and noninvasive real-time cardiac examination which is widely used in intensive care unit (ICU) patients.The purpose of this study was to analyze the effect of TTE on the prognosis of ICU patients with ARDS.Methods: The data of ARDS patients were retrieved from the MIMIC-III v1.4 database and patients were divided into the TTE group and non-TTE group. Then, the baseline data were compared between the two groups, and the effect of TTE on the prognosis of ARDS patients was analyzed through multivariate logistic analysis and the propensity score (PS).Results: A total of 1,346 ARDS patients were enrolled, including 519 (38.6%) cases in the TTE group and 827 (61.4%) cases in the non-TTE group. Compared with the non-TTE group, the 28-day mortality of patients in the TTE group was greatly improved (OR=0.64 95%CI: 0.48-0.86, P=0.003). The length of ICU stay in the TTE group was significantly shorter than that in the non-TTE group (17d vs.14d, P=0.0001). The infusion volume in the TTE group was significantly less than that of the non-TTE group (6.2L vs.5.5L on day 1, P=0.0012). Importantly, the patients in the TTE group were weaned ventilators earlier than those in the non-TTE group (ventilator-free days within 28 d: 21 d vs. 19.8 d, respectively, P = 0.071).Conclusion: TTE can lower the risk of 28-d mortality in patients with ARDS.