Invasive Hemodynamic Assessment and Classification of In-Hospital Mortality Risk Among Patients With Cardiogenic Shock.
Circ Heart Fail
cards; cards publication
BACKGROUND: Risk stratifying patients with cardiogenic shock (CS) is a major unmet need. The recently proposed Society for Cardiovascular Angiography and Interventions (SCAI) stages as an approach to identify patients at risk for in-hospital mortality remains under investigation. We studied the utility of the SCAI stages and further explored the impact of hemodynamic congestion on clinical outcomes.
METHODS: The CS Working Group registry includes patients with CS from 8 medical centers enrolled between 2016 and 2019. Patients were classified by the maximum SCAI stage (B-E) reached during their hospital stay according to drug and device utilization. In-hospital mortality was evaluated for association with SCAI stages and hemodynamic congestion.
RESULTS: Of the 1414 patients with CS, the majority were due to decompensated heart failure (50%) or myocardial infarction (MI; 35%). In-hospital mortality was 31% for the total cohort, but higher among patients with MI (41% versus 26%, MI versus heart failure,
CONCLUSIONS: Our findings support an association between the proposed SCAI staging system and in-hospital mortality among patient with heart failure and MI. We further identify that venous congestion is common and identifies patients with CS at high risk for in-hospital mortality. These findings provide may inform future management protocols and clinical studies.
Thayer, Katherine L; Zweck, Elric; Ayouty, Mohyee; Garan, A Reshad; Hernandez-Montfort, Jaime; Mahr, Claudius; Morine, Kevin J; Newman, Sarah; Jorde, Lena; Haywood, Jillian L; Harwani, Neil M; Esposito, Michele L; Davila, Carlos D; Wencker, Detlef; Sinha, Shashank S; Vorovich, Esther; Abraham, Jacob; O'Neill, William; Udelson, James; Burkhoff, Daniel; and Kapur, Navin K, "Invasive Hemodynamic Assessment and Classification of In-Hospital Mortality Risk Among Patients With Cardiogenic Shock." (2020). Articles, Abstracts, and Reports. 3650.