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Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest
Cardiogenic Shock (CS) complicated by in-hospital (IHCA) or out-of-hospital cardiac arrest (OHCA) has a poor outcome. However, studies regarding the prognostic differences between IHCA and OHCA in CS are limited. In this prospective, observational study, consecutive patients with CS were included in...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004576/ https://www.ncbi.nlm.nih.gov/pubmed/36902851 http://dx.doi.org/10.3390/jcm12052064 |
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author | Rusnak, Jonas Schupp, Tobias Weidner, Kathrin Ruka, Marinela Egner-Walter, Sascha Forner, Jan Bertsch, Thomas Kittel, Maximilian Mashayekhi, Kambis Tajti, Péter Ayoub, Mohamed Behnes, Michael Akin, Ibrahim |
author_facet | Rusnak, Jonas Schupp, Tobias Weidner, Kathrin Ruka, Marinela Egner-Walter, Sascha Forner, Jan Bertsch, Thomas Kittel, Maximilian Mashayekhi, Kambis Tajti, Péter Ayoub, Mohamed Behnes, Michael Akin, Ibrahim |
author_sort | Rusnak, Jonas |
collection | PubMed |
description | Cardiogenic Shock (CS) complicated by in-hospital (IHCA) or out-of-hospital cardiac arrest (OHCA) has a poor outcome. However, studies regarding the prognostic differences between IHCA and OHCA in CS are limited. In this prospective, observational study, consecutive patients with CS were included in a monocentric registry from June 2019 to May 2021. The prognostic impact of IHCA and OHCA on 30-day all-cause mortality was tested within the entire group and in the subgroups of patients with acute myocardial infarction (AMI) and coronary artery disease (CAD). Statistical analyses included univariable t-test, Spearman’s correlation, Kaplan–Meier analyses, as well as uni- and multivariable Cox regression analyses. A total of 151 patients with CS and cardiac arrest were included. IHCA on ICU admission was associated with higher 30-day all-cause mortality compared to OHCA in univariable COX regression and Kaplan–Meier analyses. However, this association was solely driven by patients with AMI (77% vs. 63%; log rank p = 0.023), whereas IHCA was not associated with 30-day all-cause mortality in non-AMI patients (65% vs. 66%; log rank p = 0.780). This finding was confirmed in multivariable COX regression, in which IHCA was solely associated with higher 30-day all-cause mortality in patients with AMI (HR = 2.477; 95% CI 1.258–4.879; p = 0.009), whereas no significant association could be seen in the non-AMI group and in the subgroups of patients with and CAD. CS patients with IHCA showed significantly higher all-cause mortality at 30 days compared to patients with OHCA. This finding was primarily driven by a significant increase in all-cause mortality at 30 days in CS patients with AMI and IHCA, whereas no difference could be seen when differentiated by CAD. |
format | Online Article Text |
id | pubmed-10004576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100045762023-03-11 Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest Rusnak, Jonas Schupp, Tobias Weidner, Kathrin Ruka, Marinela Egner-Walter, Sascha Forner, Jan Bertsch, Thomas Kittel, Maximilian Mashayekhi, Kambis Tajti, Péter Ayoub, Mohamed Behnes, Michael Akin, Ibrahim J Clin Med Article Cardiogenic Shock (CS) complicated by in-hospital (IHCA) or out-of-hospital cardiac arrest (OHCA) has a poor outcome. However, studies regarding the prognostic differences between IHCA and OHCA in CS are limited. In this prospective, observational study, consecutive patients with CS were included in a monocentric registry from June 2019 to May 2021. The prognostic impact of IHCA and OHCA on 30-day all-cause mortality was tested within the entire group and in the subgroups of patients with acute myocardial infarction (AMI) and coronary artery disease (CAD). Statistical analyses included univariable t-test, Spearman’s correlation, Kaplan–Meier analyses, as well as uni- and multivariable Cox regression analyses. A total of 151 patients with CS and cardiac arrest were included. IHCA on ICU admission was associated with higher 30-day all-cause mortality compared to OHCA in univariable COX regression and Kaplan–Meier analyses. However, this association was solely driven by patients with AMI (77% vs. 63%; log rank p = 0.023), whereas IHCA was not associated with 30-day all-cause mortality in non-AMI patients (65% vs. 66%; log rank p = 0.780). This finding was confirmed in multivariable COX regression, in which IHCA was solely associated with higher 30-day all-cause mortality in patients with AMI (HR = 2.477; 95% CI 1.258–4.879; p = 0.009), whereas no significant association could be seen in the non-AMI group and in the subgroups of patients with and CAD. CS patients with IHCA showed significantly higher all-cause mortality at 30 days compared to patients with OHCA. This finding was primarily driven by a significant increase in all-cause mortality at 30 days in CS patients with AMI and IHCA, whereas no difference could be seen when differentiated by CAD. MDPI 2023-03-06 /pmc/articles/PMC10004576/ /pubmed/36902851 http://dx.doi.org/10.3390/jcm12052064 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rusnak, Jonas Schupp, Tobias Weidner, Kathrin Ruka, Marinela Egner-Walter, Sascha Forner, Jan Bertsch, Thomas Kittel, Maximilian Mashayekhi, Kambis Tajti, Péter Ayoub, Mohamed Behnes, Michael Akin, Ibrahim Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title | Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title_full | Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title_fullStr | Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title_full_unstemmed | Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title_short | Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest |
title_sort | differences in outcome of patients with cardiogenic shock associated with in-hospital or out-of-hospital cardiac arrest |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004576/ https://www.ncbi.nlm.nih.gov/pubmed/36902851 http://dx.doi.org/10.3390/jcm12052064 |
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