Acute cardiac care & resuscitation
Cardiogenic shock in general intensive care unit: a nationwide prospective analysis of epidemiology and outcome
Authors' conclusion
In the general ICU, the aetiology of CS, excluding cardiac arrest, remains characterized mostly by LHF with RHF-CS burdened by higher mortality. Multiorgan failure at admission and longer hospital stay before ICU admission predispose to worsen outcome.
Study context
- Population
- Patients with cardiogenic shock (excluding cardiac arrest) admitted to general intensive care unit (ICUs), 2011–2018
- Participants
- 11,052 patients314 general ICUs
- Outcome
- Mortality
Methodological detailsmulticentre, nationwide registry (GiViTI)
- Multicentre
- Nationwide registry (GiViTI)
Main finding
As reported in the abstract
Overall ICU mortality
44.8%
Mortality during hospitalization in index hospital
53.4%
Mortality at latest hospital
54.3%
Observational data: associations, not effects.
Further findings
Mortality by cardiogenic shock (CS) aetiology · during hospitalization
| OR (95% CI) | P value | ||
|---|---|---|---|
| Right heart failure-cardiogenic shockHighest mortality risk | 1.19 (0.94–1.50) | P < 0.001 | |
| Biventricular CS | 1.04 (0.82–1.32) | ||
| 0.512Odds ratio (log scale) |
Clinical factors associated with mortality (logistic regression) · during hospitalization
| OR (95% CI) | ||
|---|---|---|
| Respiratory failure | 1.13 (1.08–1.19) | |
| Renal dysfunction | 1.55 (1.50–1.61) | |
| Neurological alteration | 1.45 (1.39–1.50) | |
| SBP < 70 mmHgSevere hypotension | 2.35 (2.06–2.67) | |
| Increasing age | 2.21 (2.01–2.42) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Clinical factors associated with mortality (logistic regression) · during hospitalizationCoagulation disorder | 1.17 (95% CI 1.1–1.24) |
Clinical factors associated with mortality (logistic regression) · during hospitalization
- Longer ICU stay prior to admission: two-fold increase for each 4.7 days
Original publication
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