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...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/5/2064 |
| _version_ | 1797614946152873984 |
|---|---|
| author | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin |
| author_facet | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin |
| author_sort | Jonas Rusnak |
| collection | DOAJ |
| 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 <i>t</i>-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 <i>p</i> = 0.023), whereas IHCA was not associated with 30-day all-cause mortality in non-AMI patients (65% vs. 66%; log rank <i>p</i> = 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; <i>p</i> = 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. |
| first_indexed | 2024-03-11T07:19:29Z |
| format | Article |
| id | doaj.art-4335a97806f9483fbe231c09694fda11 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:19:29Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4335a97806f9483fbe231c09694fda112023-11-17T08:02:08ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125206410.3390/jcm12052064Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac ArrestJonas Rusnak0Tobias Schupp1Kathrin Weidner2Marinela Ruka3Sascha Egner-Walter4Jan Forner5Thomas Bertsch6Maximilian Kittel7Kambis Mashayekhi8Péter Tajti9Mohamed Ayoub10Michael Behnes11Ibrahim Akin12Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyInstitute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, GermanyInstitute for Clinical Chemistry, Faculty of Medicine Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Internal Medicine and Cardiology, Mediclin Heart Centre Lahr, 77933 Lahr, GermanyGottsegen György National Cardiovascular Center, 1096 Budapest, HungaryDivision of Cardiology and Angiology, Heart Center University of Bochum—Bad Oeynhausen, 32545 Bad Oeynhausen, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyDepartment of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, GermanyCardiogenic 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 <i>t</i>-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 <i>p</i> = 0.023), whereas IHCA was not associated with 30-day all-cause mortality in non-AMI patients (65% vs. 66%; log rank <i>p</i> = 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; <i>p</i> = 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.https://www.mdpi.com/2077-0383/12/5/2064cardiogenic shockprognosismortalityAMIIHCAOHCA |
| spellingShingle | Jonas Rusnak Tobias Schupp Kathrin Weidner Marinela Ruka Sascha Egner-Walter Jan Forner Thomas Bertsch Maximilian Kittel Kambis Mashayekhi Péter Tajti Mohamed Ayoub Michael Behnes Ibrahim Akin Differences in Outcome of Patients with Cardiogenic Shock Associated with In-Hospital or Out-of-Hospital Cardiac Arrest Journal of Clinical Medicine cardiogenic shock prognosis mortality AMI IHCA OHCA |
| 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 | cardiogenic shock prognosis mortality AMI IHCA OHCA |
| url | https://www.mdpi.com/2077-0383/12/5/2064 |
| work_keys_str_mv | AT jonasrusnak differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT tobiasschupp differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT kathrinweidner differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT marinelaruka differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT saschaegnerwalter differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT janforner differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT thomasbertsch differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT maximiliankittel differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT kambismashayekhi differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT petertajti differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT mohamedayoub differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT michaelbehnes differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest AT ibrahimakin differencesinoutcomeofpatientswithcardiogenicshockassociatedwithinhospitaloroutofhospitalcardiacarrest |