Use of the pulmonary artery catheter is not associated with worse outcome in the ICU.
OBJECTIVE
In critically ill patients, the impact of pulmonary artery catheter (PAC) use on outcome is debatable. We investigated the epidemiology of PAC use in European ICUs and its relation to outcome.


METHODS
International cohort, observational study.


METHODS
One hundred ninety-eight European ICUs participating in the Sepsis Occurrence in Acutely Ill Patients Study.


METHODS
All 3,147 adult patients admitted to one of the participating ICUs between May 1, 2002, and May 15, 2002.


METHODS
None.


RESULTS
Patients were classified according to whether or not they had a PAC at any time during their ICU stay, and were followed up until death, hospital discharge, or for 60 days. Propensity score case matching was performed, and matched pairs were examined for baseline characteristics and outcome. Of 3,147 patients, 481 patients (15.3%) had a PAC. Patients with a PAC were older, had a higher incidence of heart failure, a lower incidence of cancer, and were more commonly surgical admissions. Fluid balance was comparable between the two groups. ICU and hospital mortality rates were higher in patients with a PAC (28.1% vs 16.8% and 32.5% vs 22.5%, respectively; p < 0.001). However, PAC use was not an independent risk factor for 60-day mortality in multivariate analysis, and in 453 propensity-matched pairs ICU and hospital mortality rates were comparable between groups (26.7% vs 26.3% and 31.4% vs 32.8%, p = not significant). Survival to 60 days was similar between the two matched groups (log rank = 0.02; p = 0.894).


CONCLUSIONS
This observational study suggests that PAC use is not associated with increased mortality in this heterogeneous population.
Sakr
Yasser
Y
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Route de Lennik 808, B-1070 Brussels, Belgium.
Vincent
Jean-Louis
JL
Reinhart
Konrad
K
Payen
Didier
D
Wiedermann
Christian J
CJ
Zandstra
Durk F
DF
Sprung
Charles L
CL
D002404:Catheterization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome