Cohort study
Clinical Presentation, Classification, and Outcomes of Cardiogenic Shock in Children
- Retrospective cohort study
- single-centre
- consecutive hospitalizations
Authors' conclusion
CS occurs in 26% of pediatric hospitalizations for ADHF and is independently associated with hospital mortality. A modified Society for Cardiovascular Angiography and Interventions classification for CS severity showed robust association with increasing mortality.
Study context
- Population
- Children (<21 years) hospitalized for acute decompensated HF
- Participants
- 591 children · 803 acute decompensated heart failure (ADHF) hospitalizations
- Exposure
- Cardiogenic shock (CS) vs no CS among children hospitalized for ADHF
- CSn = 207
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
In-hospital mortality (most recent ADHF hospitalization)
Odds ratio
1.91
95% CI 1.05–3.45
P = 0.033
By group
CS vs No CS
OR 1.91 (95% CI 1.05–3.45); P = 0.033
Observational data: associations, not effects.
Further findings
Mechanical ventilation and mechanical circulatory support
Mechanical ventilation
Mechanical circulatory support
- Incidence of CS among ADHF hospitalizations
- 26% · 207 of 207
- Mechanical ventilation and mechanical circulatory support: both P < 0.001
Inpatient mortality by modified SCAI CS stage
- Each higher CS stage associated with greater inpatient mortality (OR 2.40-8.90)
- all P < 0.001
Clinical features of CS vs no CS
- Worse systolic function with CS
- P = 0.040
- Higher B-type natriuretic peptide with CS
- P = 0.032
- More frequent early severe renal injury with CS
- P = 0.023
- More frequent early severe liver injury with CS
- P < 0.001
Original publication
Clinical Presentation, Classification, and Outcomes of Cardiogenic Shock in Children. J Am Coll Cardiol. Published 6 February 2024. doi:10.1016/j.jacc.2023.11.019
Summarised from the published abstract; every number is checked against it