Differences in outcome of patients with cardiogenic shock associated with in-hospital or out-of-hospital cardiac arrest

• Verfasst von: Rusnak, Jonas [VerfasserIn]
• Verfasst von: Schupp, Tobias [VerfasserIn]
• Verfasst von: Weidner, Kathrin [VerfasserIn]
• Verfasst von: Ruka, Marinela [VerfasserIn]
• Verfasst von: Egner-Walter, Sascha [VerfasserIn]
• Verfasst von: Forner, Jan [VerfasserIn]
• Verfasst von: Bertsch, Thomas [VerfasserIn]
• Verfasst von: Kittel, Maximilian [VerfasserIn]
• Verfasst von: Mashayekhi, Kambis [VerfasserIn]
• Verfasst von: Tajti, Péter [VerfasserIn]
• Verfasst von: Ayoub, Mohamed [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Differences in outcome of patients with cardiogenic shock associated with in-hospital or out-of-hospital cardiac arrest
• Verf.angabe: 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 and Ibrahim Akin
• E-Jahr: 2023
• Jahr: 6 March 2023
• Umfang: 14 S.
• Fussnoten: Gesehen am 24.04.2023
• Titel Quelle: Enthalten in: Journal of Clinical Medicine
• Ort Quelle: Basel : MDPI, 2012
• Jahr Quelle: 2023
• Band/Heft Quelle: 12(2023), 5, Artikel-ID 2064, Seite 1-14
• ISSN Quelle: 2077-0383
• DOI: doi:10.3390/jcm12052064
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: AMI
• Sach-SW: cardiogenic shock
• Sach-SW: IHCA
• Sach-SW: mortality
• Sach-SW: OHCA
• Sach-SW: prognosis
• K10plus-PPN: 1843388316

Abstract

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.