Acute cardiac care & resuscitationCohort study
Higher Hospital Volume is Associated with Lower Mortality for Patients with Cardiogenic Shock and Mechanical Circulatory Support
- Retrospective cohort study
- nationwide
- adjusted Cox regression
Authors' conclusion
Care for patients with CS treated with and without MCS is associated with lower in-hospital mortality in hospitals that manage high volumes of CS and MCS.
Study context
- Population
- All patients with cardiogenic shock treated in Germany, 2017–2021
- Participants
- 220,223 patients · 1,232 hospitals
- Exposure
- Higher vs lower annual hospital cardiogenic shock (CS)/mechanical circulatory support (MCS) volume
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
Upper third vs Lower two-thirdsHazard ratio (95% CI)P value
CS volume
0.92(0.91–0.94)
P < 0.001MCS volume
0.80(0.76–0.84)
P < 0.001Observational data: associations, not effects.
Further findings
Volume thresholds (spline plots)
- Continuous association without detectable ceiling effect; suggested thresholds ≥90 CS cases/25 MCS cases per year
Hospitals performing MCS
- Hospitals performing MCS therapy
- 435/1232 (35%)
- Hospitals performing >25 MCS cases per year on average
- 60/435, 14%
Original publication
Higher Hospital Volume is Associated with Lower Mortality for Patients with Cardiogenic Shock and Mechanical Circulatory Support. Eur J Heart Fail. Published 31 August 2025. doi:10.1002/ejhf.70025
Summarised from the published abstract; every number is checked against it