Impact of shock aetiology and hospital characteristics on the clinical profile, management and prognosis of patients with non ACS-related cardiogenic shock.

Autor:	Barrionuevo-Sánchez MI; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Ariza-Solé A; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: aariza@bellvitgehospital.cat., Prado ND; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain., García M; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain., Sánchez-Salado JC; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Lorente V; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Alegre O; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Llaó I; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Bernal JL; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain., Fernández-Pérez C; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain; Servicio de Medicina Preventiva, Área Sanitaria de Santiago y Barbanza, Instituto de Investigaciones Sanitarias de Santiago, Santiago de Compostela (A Coruña), Spain., Galván-Román F; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Cuerda F; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Pascual J; Hospital Josep Trueta, Girona, Spain., Cequier A; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Comin-Colet J; Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bioheart. Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: jcomin@bellvitgehospital.cat., Elola FJ; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2023 Jan-Feb; Vol. 69, pp. 16-23. Date of Electronic Publication: 2022 Nov 02.
DOI:	10.1016/j.hjc.2022.11.001
Abstrakt:	Background: A significant proportion of cases of cardiogenic shock (CS) are due aetiologies other than acute coronary syndromes (non ACS-CS). We assessed differences regarding clinical profile, management, and prognosis according to the cause of CS among nonselected patients with CS from a large nationwide database. Methods: We performed an observational study including patients admitted from the hospitals of the Spanish National Health System (SNHS) with a principal or secondary diagnosis code of CS (2016-2019). Data were obtained from the Minimum Basic Data Set (MBDS). Hospitals were classified according to the availability of cardiology related resources, as well as the availability of Intensive Cardiac Care Unit (ICCU). Results: A total of 10,826 episodes of CS were included, of whom 5,495 (50.8%) were non-ACS related. Non ACS-CS patients were younger (71.5 vs. 72.4 years) and had a lower burden of arteriosclerosis-related comorbidities. Non ACS-CS cases underwent less often invasive procedures and presented lower in-hospital mortality (57.1% vs. 61%,p < 0.001). The most common main diagnosis among non ACS-CS was acute decompensation of chronic heart failure (ADCHF) (35.4%). A lower risk-adjusted in-hospital mortality rate was observed in high volume hospitals (52.6% vs. 56.7%; p < 0.001), as well as in centers with ICCU (OR: 0.71; CI 95%: 0.58-0.87; p < 0.001). Conclusions: More than a half of cases of CS were due to non-ACS causes. Non ACS-CS cases are a very heterogeneous group, with different clinical profile and management. Management at high-volume hospitals and availability of ICCU were associated with lower risk adjusted mortality among non ACS-CS patients. Competing Interests: Conflict of Interest Statement The authors declare they have no conflict of interest. (Copyright © 2022 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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