Modes of Death in Patients with Cardiogenic Shock in the Cardiac Intensive Care Unit: A Report from the Critical Care Cardiology Trials Network.
Publication/Presentation Date
2-20-2024
Abstract
BACKGROUND: There are limited data on how patients with cardiogenic shock (CS) die.
METHODS: CCCTN is a research network of cardiac intensive care units coordinated by the TIMI Study Group (Boston, MA). Using standardized definitions, site investigators classified direct modes of in-hospital death for CS admissions (10/2021-09/2022). Mutually exclusive categories included 4 modes of cardiovascular death and 4 modes of non-cardiovascular death. Subgroups defined by CS type, preceding cardiac arrest (CA), use of temporary mechanical circulatory support (tMCS), and transition to comfort measures were evaluated.
RESULTS: Among 1,068 CS cases, 337 (31.6%) died during the index hospitalization. Overall, mode of death was cardiovascular in 82.2%. Persistent CS was the dominant specific mode of death (66.5%), followed by arrhythmia (12.8%), anoxic brain injury (6.2%), and respiratory failure (4.5%). Patients with preceding CA were more likely to die from anoxic brain injury (17.1% vs. 0.9%;p
CONCLUSIONS: Most deaths in CS are related to direct cardiovascular causes, particularly persistent CS. However, there is important heterogeneity across subgroups defined by preceding CA and use of tMCS.
ISSN
1532-8414
Published In/Presented At
Berg, D. D., Singal, S., Palazzolo, M., Baird-Zars, V. M., Bofarrag, F., Bohula, E. A., Chaudhry, S. P., Dodson, M. W., Hillerson, D., Lawler, P. R., Liu, S., O'Brien, C. G., Pisani, B. A., Racharla, L., Rowsell, R. O., Shah, K. S., Solomon, M. A., Sridharan, L., Thompson, A. D., Diepen, S. V., … CCCTN Investigators (2024). Modes of Death in Patients with Cardiogenic Shock in the Cardiac Intensive Care Unit: A Report from the Critical Care Cardiology Trials Network. Journal of cardiac failure, S1071-9164(24)00042-3. Advance online publication. https://doi.org/10.1016/j.cardfail.2024.01.012
Disciplines
Medicine and Health Sciences
PubMedID
38387758
Department(s)
Department of Medicine, Fellows and Residents
Document Type
Article