Acute cardiac care & resuscitation
Mixed Shock Complicating Cardiogenic Shock: Frequency, Predictors, and Clinical Outcomes
Authors' conclusion
MS complicating CS, objectively defined leveraging on longitudinal changes in distributive and inflammatory features, occurs in one-fourth of patients with CS, is predicted by markers of CS severity and inflammation at CS diagnosis, and portends higher hospital mortality.
Study context
- Population
- Patients hospitalised with pure cardiogenic shock in cardiac ICUs (67±13 years, 96% SCAI stage C or higher)13 of 213 excluded
- Participants
- 200 patients
- Exposure
- Mixed shock vs pure cardiogenic shock
- Outcome
- Frequency, predictors and prognostic relevance of MS complicating CS
Methodological details2 cardiac ICUs, consecutive patients
- 2 cardiac ICUs
- Consecutive patients
Main finding
As reported in the abstract
Frequency of MS complicating CS · after 120 (29-216) hours from CS diagnosis
Mixed shock (MS)
24.5%
- Independent predictors of MS at cardiogenic shock (CS) diagnosis: lower SBP
- P = 0.043
- Independent predictor: hepatic injury
- P = 0.049
- Independent predictor: suspected/definite infection
- P = 0.013
Observational data: associations, not effects.
Further findings
Predictors of in-hospital death (logistic multivariable analysis)
| Estimate | P value | ||
|---|---|---|---|
| MS diagnosis | OR 3.00 (95% CI 1.39–6.63) | Padj=0.006 | |
| Admission systolic arterial pressure <100 mm Hg | OR 2.41 (95% CI 1.19–4.98) | Padj=0.016 | |
| Age | OR 1.06 years (95% CI 1.03–1.10) | Padj<0.001 | |
| Admission serum creatinine | OR 1.61 (95% CI 1.19–2.26) | Padj=0.003 | |
| Early temporary mechanical circulatory supportLower in-hospital death | OR 0.36 (95% CI 0.17–0.75) | Padj=0.008 | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | MS |
|---|---|
| In-hospital mortality and hospital stay | 53.1% |
| Hospital stay | 21 [13-48] days |
- In-hospital mortality and hospital stay: Pure CS 27.8% · Hospital stay 17 [9-27] days
- In-hospital mortality and hospital stay: In-hospital mortality P=0.002
- In-hospital mortality and hospital stay: Hospital stay P=0.018
Independent predictors of MS development (at CS diagnosis)
- Lower systolic arterial pressure
- P = 0.043
- Hepatic injury
- P = 0.049
- Suspected/definite infection
- P = 0.013
Original publication
Mixed Shock Complicating Cardiogenic Shock: Frequency, Predictors, and Clinical Outcomes. Circ Heart Fail. Published 9 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →