Positive fluid balance is associated with increased in-hospital mortality in patients with intracerebral hemorrhage

ABSTRACT

Objective: This study aimed to investigate the association between fluid balance (FB) and in-hospital mortality in patients with intracerebral hemorrhage (ICH).

Methods: Data were extracted from the online database Multi-parameter Intelligent Monitoring in Intensive Care III. Patients were divided into two groups according to the FB status at 48 hours after intensive care unit (ICU) admission: negative and positive 48-hour FB groups. The primary outcome was in-hospital mortality.

Results: Data of 1407 patients were analyzed. Linear spline function in logistic models showed significant association between the volume of positive FB and in-hospital mortality (odds ratio (OR) 1.006; 95% CI: 1.002–1.010), while the association between the volume of negative FB and in-hospital mortality was non-significant. For interpretation, FB was further divided into four quartiles. Referred to Q1, the OR of in-hospital mortality stepwise increased from Q2 (OR, 1.11; 95% CI: 0.72–1.68) to Q4 (OR, 1.68; 95% CI: 1.13–2.48). A similar association was also found between FB and Glasgow coma scale at ICU discharge.

Conclusions: In patients with ICH, increased volume of positive FB was associated with higher in-hospital mortality while the volume of negative FB was not. Whether maintaining a zero FB status is a beneficial strategy needs further investigation.

KEYWORDS:

• Fluid balance
• critical care
• intracerebral hemorrhage
• mortality
• MIMIC III

Declaration of interest

The authors declare that they have no conflict of interest.

Informed consent

All information obtained from the MIMIC III database and were anonymized. Therefore, the need for informed consent was waived.

Supplementary data

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Additional information

Notes on contributors

Yanfei Shen

Yanfei Shen is senior physician of ICU and are experienced in critical care of patients with cerebreal hemorrhage.

Xinmei Huang

Xinmei Huang is experienced in statistics.

Yongxia Hu

Yongxia Hu is senior physician of ICU and are experienced in critical care of patients with cerebreal hemorrhage.

Weimin Zhang

Weimin Zhang is senior physician of ICU and are experienced in critical care of patients with cerebreal hemorrhage.

Liquan Huang

Liquan Huang is senior physician of ICU and are experienced in critical care of patients with cerebreal hemorrhage.