Associations of estimated plasma volume status with 30-day mortality and 1-year mortality in patients with intracerebral hemorrhage: A study of the MIMIC-IV database and the Hospital Information System

Yongze Shen ^* Yingjie Shen Yaolou Wang Renjie Hu Hangjia Xu Yuyang Feng Yang Yang Xiangtong Zhang Hongsheng Liang

• First Affiliated Hospital of Harbin Medical University, Harbin, China

Aim: This study aims to investigated the associations between estimated plasma volume status (ePVS) and 30-day and 1-year mortality in intracerebral hemorrhage (ICH) patients, providing insights into the management in ICH. Methods: Data of adult ICH patients were extracted from both the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the Hospital Information System (HIS) in this retrospective cohort study. Univariate and multivariate Cox regression analyses , and restricted cubic spline plots (RCS) were conducted to explore the associations between ePVS levels and both 30-day and 1-year mortality, with hazard ratios (HR) and 95% confidence intervals (CI) used for evaluation. Subgroup analyses were performed to further investigate these associations. Results: Among 2,512 eligible patients from the MIMIC-IV database, 655 (26.07%) died within 30 days, with 1,254 (49.92%) had died by the 1-year follow-up. After adjusting for covariates, elevated ePVS was independently associated with both 30-day mortality (HR=1.05, 95%CI: 1.01-1.09) and 1-year mortality (HR=1.09, 95% CI: 1.06-1.13). Compared to patients with ePVS levels of [4.63-5.79), those with ePVS levels ≥5.79 had a higher risk of 30-day mortality (HR: 1.36, 95%CI: 1.12-1.64) and 1-year mortality (HR=1.24, 95% CI: 1.08-1.42).Among 515 eligible patients from the HIS, 132 (25.60%) died within 30 days, with 288 (55.90%) mortality observed at 1-year follow-up. After adjusting for covariates, elevated ePVS was independently associated with both 30-day mortality (HR=1.33, 95%CI: 1.23-1.43) and 1-year mortality (HR=1.26, 95% CI: 1.18-1.35). Comparing to patients with ePVS levels of [4.63-5.79), those with ePVS levels of ≥5.79 had a higher risk of 30-day mortality (HR:2.21, 95%CI: 1.48-3.30) and and 1-year mortality (HR=2.75, 95% CI: 2.04-3.72). Additionally, subgroup analyses demonstrated that ePVS was significantly associated with 30-day mortality or 1-year mortality derived from MIMIC-IV and HIS in most subgroups (P<0.05). And RCS analysis indicates that, whether using MIMIC-IV or HIS data, ePVS was linearly associated with 30-day or 1-year mortality.Higher ePVS levels may be a potential risk factor for 30-day and 1-year mortality in ICH patients, suggesting that timely monitoring and stabilization of ePVS could improve prognosis in this population. However, further studies are needed to validate these fingings.