EPidemiology Of Cardiogenic sHock in Scotland (EPOCHS): A multicentre, prospective observational study of the prevalence, management and outcomes of cardiogenic shock in Scotland.

Autor:	Warren A; Royal Infirmary of Edinburgh, Edinburgh, UK.; Anaesthesia, Critical Care & Pain, University of Edinburgh, Edinburgh, UK.; Barts Heart Centre, London, UK., McCall P; Golden Jubilee National Hospital, Clydebank, UK.; Anaesthesia, Critical Care & Peri-Operative Medicine, University of Glasgow, Glasgow, UK., Proudfoot A; Barts Heart Centre, London, UK.; Queen Mary University of London, London, UK., Gillon S; Royal Infirmary of Edinburgh, Edinburgh, UK., Abu-Arafeh A; Royal Infirmary of Edinburgh, Edinburgh, UK., McKnight AJ; Royal Infirmary of Edinburgh, Edinburgh, UK., Mudie R; Royal Infirmary of Edinburgh, Edinburgh, UK., Armstrong D; Royal Infirmary of Edinburgh, Edinburgh, UK., Tzolos E; Royal Infirmary of Edinburgh, Edinburgh, UK., Livesey JA; Royal Infirmary of Edinburgh, Edinburgh, UK., Sinclair A; Golden Jubilee National Hospital, Clydebank, UK., Baston V; Golden Jubilee National Hospital, Clydebank, UK., Dalzell J; Golden Jubilee National Hospital, Clydebank, UK., Owen D; Aberdeen Royal Infirmary, Aberdeen, UK., Fleming L; Aberdeen Royal Infirmary, Aberdeen, UK., Scott I; Aberdeen Royal Infirmary, Aberdeen, UK., Puxty A; Glasgow Royal Infirmary, Glasgow, UK., Lee MM; Glasgow Royal Infirmary, Glasgow, UK., Walker F; Hairmyres Hospital, East Kilbride, UK., Hobson S; Hairmyres Hospital, East Kilbride, UK., Campbell E; Ninewells Hospital, Dundee, UK., Kinsella M; Ninewells Hospital, Dundee, UK., McGinnigle E; Queen Elizabeth University Hospital, Glasgow, UK., Docking R; Queen Elizabeth University Hospital, Glasgow, UK., Price G; St. John's Hospital, Livingston, UK., Ramsay A; Victoria Hospital, Kirkcaldy, UK., Bauld R; Victoria Hospital, Kirkcaldy, UK., Herron S; Wishaw Hospital, Wishaw, UK., Lone NI; Royal Infirmary of Edinburgh, Edinburgh, UK.; Anaesthesia, Critical Care & Pain, University of Edinburgh, Edinburgh, UK.; Usher Institute, University of Edinburgh, Edinburgh, UK., Mills NL; Royal Infirmary of Edinburgh, Edinburgh, UK.; Usher Institute, University of Edinburgh, Edinburgh, UK.; BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK., Hartley L; Royal Infirmary of Edinburgh, Edinburgh, UK.
Jazyk:	angličtina
Zdroj:	Journal of the Intensive Care Society [J Intensive Care Soc] 2023 Dec 28; Vol. 25 (2), pp. 147-155. Date of Electronic Publication: 2023 Dec 28 (Print Publication: 2024).
DOI:	10.1177/17511437231217877
Abstrakt:	Background: Despite high rates of cardiovascular disease in Scotland, the prevalence and outcomes of patients with cardiogenic shock are unknown. Methods: We undertook a prospective observational cohort study of consecutive patients with cardiogenic shock admitted to the intensive care unit (ICU) or coronary care unit at 13 hospitals in Scotland for a 6-month period. Denominator data from the Scottish Intensive Care Society Audit Group were used to estimate ICU prevalence; data for coronary care units were unavailable. We undertook multivariable logistic regression to identify factors associated with in-hospital mortality. Results: In total, 247 patients with cardiogenic shock were included. After exclusion of coronary care unit admissions, this comprised 3.0% of all ICU admissions during the study period (95% confidence interval [CI] 2.6%-3.5%). Aetiology was acute myocardial infarction (AMI) in 48%. The commonest vasoactive treatment was noradrenaline (56%) followed by adrenaline (46%) and dobutamine (40%). Mechanical circulatory support was used in 30%. Overall in-hospital mortality was 55%. After multivariable logistic regression, age (odds ratio [OR] 1.04, 95% CI 1.02-1.06), admission lactate (OR 1.10, 95% CI 1.05-1.19), Society for Cardiovascular Angiographic Intervention stage D or E at presentation (OR 2.16, 95% CI 1.10-4.29) and use of adrenaline (OR 2.73, 95% CI 1.40-5.40) were associated with mortality. Conclusions: In Scotland the prevalence of cardiogenic shock was 3% of all ICU admissions; more than half died prior to discharge. There was significant variation in treatment approaches, particularly with respect to vasoactive support strategy. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Intensive Care Society 2023.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu