Acute cardiac care & resuscitationSecondary analysis
Prognostic Impact of Admission Time in Infarct-Related Cardiogenic Shock
- Secondary analysis of the ECLS-SHOCK randomised trial
- multicentre
Authors' conclusion
The prognosis in AMI-CS was not affected by admission time with a similar effect of ECLS during on- and off-hours.
Study context
- Population
- Patients with AMI complicated by cardiogenic shock enrolled in ECLS-SHOCK, 2019–2022
- Participants
- 417 patients
- Comparison
- Off-hours vs on-hours admission; Extracorporeal life support (ECLS) vs no ECLS by admission time
- Off-hoursn = 202
- On-hoursn = 215reference
- Primary endpoint
- All-cause mortality
- Follow-up
- 30 days
Primary result
30-day all-cause mortality
Odds ratio
0.83
95% CI 0.56–1.22
Events by treatment group
Off-hours vs On-hours
OR 0.83 (95% CI 0.56–1.22)
As reported in the abstract
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| 30-day all-cause mortality, ECLS vs no ECLS, on-hours admission (subgroup) · 50.5% [n = 52/103] vs 50.9% [n = 57/112] | 0.98 (0.58–1.68) | P = 0.95 | |
| 30-day all-cause mortality, ECLS vs no ECLS, off-hours admission (subgroup) · 45.3% [n = 48/106] vs 46.9% [n = 45/96] | 0.94 (0.54–1.63) | P = 0.82 | |
| 0.512Odds ratio (log scale) |
Safety
Bleeding events with ECLS
- ECLS associated with increased risk of bleeding, especially with on-hours admission
Original publication
Prognostic Impact of Admission Time in Infarct-Related Cardiogenic Shock. JACC Cardiovasc Interv. Published 14 October 2024. doi:10.1016/j.jcin.2024.08.013
Summarised from the published abstract; every number is checked against it