Association between Estimated Pulse Wave Velocity (ePWV) and in-hospital and ICU 28-day mortality in ischemic stroke patients: A retrospective analysis of the MIMIC-IV database

作者：Shuhe Zhao, Mingjie Liu, Minheng Zhang, Hongwei Liu, Xuan Chen, Yu Wang · 发表于：PLoS ONE · 年份：2025 · DOI：10.1371/journal.pone.0328818 · 被引用次数：4 · 研究领域：Cardiovascular Health and Disease Prevention、Non-Invasive Vital Sign Monitoring、Hemodynamic Monitoring and Therapy

BACKGROUND: Ischemic stroke poses a substantial global health burden. Reliable biomarkers for risk stratification in critically ill stroke patients are lacking. This study investigates estimated pulse wave velocity (ePWV), a non-invasive measure of arterial stiffness, as a novel prognostic indicator for mortality in this population. METHODS: This retrospective cohort study analyzed data from 3,408 adult ischemic stroke patients admitted to the ICU within the MIMIC-IV database. Patients were categorized by ePWV tertiles. The primary outcome was 28-day mortality (in-hospital and ICU). Multivariate Cox regression models were employed to assess the association between ePWV and mortality, adjusting for comprehensive clinical variables. RESULTS: Of the 3,408 patients, 481 (14.1%) died within 28 days of hospitalization. Non-survivors demonstrated significantly higher ePWV values (11.19 vs. 10.57, P < 0.001). Multivariate analysis revealed that ePWV was an independent predictor of both in-hospital (HR = 1.16, 95% CI: 1.05-1.28, P = 0.0033) and ICU 28-day mortality (HR = 1.31, 95% CI: 1.16-1.48, P < 0.0001). Subgroup analyses revealed significant interactions between ePWV and atrial fibrillation for in-hospital mortality (P = 0.0498) and mechanical ventilation for ICU mortality (P = 0.0294). For in-hospital mortality, the ePWV-associated risk was higher in patients with atrial fibrillation (HR 1.19, 95% CI: 1.07-1.31) compared to those without (HR 1.10, 95% CI: 0.98-1.23). For ICU mor...