Acute cardiac care & resuscitation
Trends and Outcomes of Cardiogenic Shock in Patients With End-Stage Renal Disease: Insights From USRDS Database
Authors' conclusion
The incidence of CS in end-stage renal disease patients has doubled without significant change in the trend of index mortality despite the use of percutaneous mechanical support.
Study context
- Population
- ESRD (CKD stage V on hemodialysis) patients hospitalised with cardiogenic shock, 2006–2019
- Participants
- 43,825 participants
- Outcome
- Trends of CS incidence, percutaneous mechanical support use, index, 30-day and 1-year all-cause mortality
Methodological detailsUS Renal Data System database
- US Renal Data System database
Main finding
As reported in the abstract
Incidence of cardiogenic shock (CS), 2006 to 2019 (per 100 000 patients)
275 to 578; Ptrend<0.001
Index mortality, 2006 to 2019 (not significant)
54.1% to 40.8%; Ptrend=0.44
1-year all-cause mortality, 2006 to 2018 (not significant)
63% to 61.8%; Ptrend=0.73
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Index mortality, percutaneous mechanical supportvs none (adjusted)Adjusted for covariates | 0.97 (0.91–1.02) | P = 0.22 | |
| 0.512Odds ratio (log scale) |
Mechanical support utilisation trends · 2006–2019
- Intra-aortic balloon pump use decreased
- 17 832 to 7992; Ptrend<0.001
- Percutaneous ventricular assist device use increased
- 137 to 5201; Ptrend<0.001
- ECMO use increased (per 100 000 patients)
- 69 to 904; Ptrend<0.001
Independent predictors of higher index mortality
- Older age, PAD, DM and time on dialysis
- Multivariable regression
Original publication
Trends and Outcomes of Cardiogenic Shock in Patients With End-Stage Renal Disease: Insights From USRDS Database. Circ Heart Fail. Published 28 July 2023. doi:10.
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