ArticleBMJ open2026
Cardiopulmonary instability score and in-hospital mortality in critically ill patients with cardiovascular disease: a retrospective eICU cohort study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo explore the association between a four-item cardiopulmonary instability (CPI) score assessed during the first 24 hours of intensive care unit (ICU) admission and in-hospital mortality among critically ill adults with cardiovascular disease.
designRetrospective multicentre cohort study.
settingThe eICU Collaborative Research Database, comprising ICU admissions from hospitals in the USA during 2014-2015.
participantsEligible ICU stays among adults aged ≥18 years with cardiovascular disease and known hospital outcome status. The ICU stay was the unit of analysis. EXPOSURE: The first 24-hour CPI score assigned one point each for hypotension, hypoxaemia, tachycardia and mechanical ventilation, yielding a total score ranging from 0 to 4. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was in-hospital mortality. Secondary outcomes were ICU mortality and prolonged ICU and hospital stays.
resultsThe cohort included 61 273 eligible ICU stays contributed by 49 991 patients across 206 hospitals; 8238 stays (13.4%) resulted in in-hospital death. All four CPI components were available for 55 601 stays (90.7%). Mortality increased from 1.4% with CPI 0 to 4.6%, 11.6% and 28.0% with CPI 1, 2 and 3-4, respectively. In the adjusted analysis, CPI≥2 was associated with in-hospital mortality (OR 4.45, 95% CI 4.06 to 4.89; relative risk 3.64, 95% CI 3.35 to 3.97). CPI alone had moderate apparent discrimination (area under the receiver operating characteristic curve 0.732, 95% CI 0.726 to 0.738). At the CPI≥2 threshold, sensitivity was 90.4%, specificity 39.4%, positive predictive value 18.8% and negative predictive value 96.3%. Findings were consistent in analyses excluding mechanical ventilation, restricting stays to >24 hours and accounting for repeated stays. CPI ≥2 was also associated with secondary outcomes.
conclusionsIn this retrospective multicentre eICU cohort, higher first-day CPI scores were associated with progressively greater in-hospital mortality, while CPI≥2 was associated with ICU mortality and prolonged ICU and hospital stays. CPI provides a simple descriptive summary of first-day CPI, but its moderate apparent discrimination and low positive predictive value do not support stand-alone use for individual prognostication or treatment decisions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.