Predictors of in-hospital mortality among cardiogenic shock patients. Prognostic and therapeutic implications

Cardiogenic shock (CS) has a poor prognosis. The heterogeneity in the mortality through different subgroups suggests that some factors can be useful to perform risk stratification and guide management. We aimed to find predictors of in-hospital mortality in these patients. We analyzed all cases of cardiogenic shock due to medical conditions admitted in our intensive acute cardiovascular care unity from November 2010 till November 2015. Clinical, biochemical and hemodynamic variables were registered, as was the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile at 24 h of CS diagnosis. From a total of 281 patients, 28 died within the first 24 h and were not included in the analysis. A total of 253 patients survived the first 24 h, mean age was 68.8 ± 14.4 years, and 174 (68.8%) were men. Etiologies: acute coronary syndrome 146 (57.7%), acute heart failure 60 (23.7%), arrhythmias 35 (13.8%), and others 12 (4.8%). A total of 91 patients (36.0%) died during hospitalization. We found the following independent predictors of in-hospital mortality: age (odds ratio [OR] 1.032, 95% confidence interval [CI] 1.003–1.062), blood glucose (OR 1.004, 95% CI 1.001–1.008), heart rate (OR 1.014, 95% CI 1.001–1.028), and INTERMACS profile (OR 0.168, 95% CI 0.107–0.266). In patients with CS the INTERMACS profile at 24 h of diagnosis was associated with higher in-hospital mortality. This and other prognostic variables (age, blood glucose, and heart rate) may be useful for risk stratification and to select appropriate medical or invasive interventions.Sin financiación6.189 JCR (2016) Q1, 16/126 Cardiac and Cardiovascular SystemsUE

Reanimación cardiopulmonar con ECMO percutáneo en parada cardiaca refractaria hospitalaria: experiencia de un centro

Sin financiación4.642 JCR (2019) Q1, 30/138 Cardiac & Cardiovascular Systems0.473 SJR (2019) Q3, 196/364 Cardiology and Cardiovascular MedicineNo data IDR 2019UE

Emergent Bedside and Anticoagulation-free Veno-venal Extracorporeal Oxygenation Membrane Cannulation in a Patient with Massive Hemoptysis and Unresponsive Shock

Sin financiación4.872 JCR (2020) Q2, 18/64 Respiratory System0.302 SJR (2020) Q3, 96/139 Pulmonary and Respiratory MedicineNo data IDR 2020UE

Canulación urgente a pie de cama y sin anticoagulación de membrana de oxigenación extracorpórea venovenosa en un paciente con hemoptisis masiva y shock refractario

Sin financiación4.872 JCR (2020) Q2, 18/64 Respiratory System0.302 SJR (2020) Q3, 96/139 Pulmonary and Respiratory MedicineNo data IDR 2020UE

Use of Extracorporeal Membrane Oxygenator in Massive Pulmonary Embolism

Sin financiación4.642 JCR (2019) Q1, 30/138 Cardiac & Cardiovascular Systems0.473 SJR (2019) Q3, 196/362 Cardiology and Cardiovascular MedicineNo data IDR 2019UE

Cardiopulmonary resuscitation with percutaneous ECMO in refractory in-hospital cardiac arrest: a single-center experience

Sin financiación4.642 JCR (2019) Q1, 30/138 Cardiac & Cardiovascular Systems0.473 SJR (2019) Q3, 196/362 Cardiology and Cardiovascular MedicineNo data IDR 2019UE

Lethal heparin-induced thrombocytopenia after transfemoral aortic valve implantation

Sin financiación6.189 JCR (2016) Q1, 16/126 Cardiac and Cardiovascular SystemsUE

Clinical Profile and Ventricular Arrhythmias after Sacubitril/Valsartan Initiation

Sin financiación1.791 JCR (2019) Q3, 93/138 Cardiac & Cardiovascular Systems0.559 SJR (2019) Q2, 166/362 Cardiology and Cardiovascular Medicine, 125/263 Pharmacology (medical)No data IDR 2019UE

Seasonality in Mortality in a Cardiology Department: A Five-Year Analysis in 500 Patients

Background: Previous studies have indicated that cardiovascular mortality follows a seasonal trend. The aim of this work was to determine the evolution of mortality throughout the year in a cardiology department. Methods: All admissions and deaths occurring in our Cardiology Department over a 5-year period (2013–2017) were recorded retrospectively. Results: From a total of 17,829 hospital admissions, 500 patients died (2.8%, 0.3 patients/day). The mean age of deceased patients was 74.2 ± 13.1 years, and 186 (37.2%) were women. Mortality ranged from 0.17 deaths/day in August to 0.40 deaths/day in February (p = 0.03), and from 0.20 deaths/day in summer to 0.36 deaths/day in winter (p = 0.001). There was also a trend towards a variation in hospitalizations, with a peak in January (10.5 admissions/day) and the lowest figure in August (7.0 admissions/day), p = 0.047. We found no significant seasonal trend regarding mortality rate with respect to the number of hospital admissions (p = 0.89). The most common cause of death was refractory heart failure (267 patients [65.8%]). A noncardiac cause of death was observed in 134 patients (26.8%). Conclusions: In a cardiology department, there are twice as many deaths in winter as in summer. Hospitalizations also tend to be more frequent in winter than in summer.Sin financiación1.791 JCR (2019) Q3, 93/138 Cardiac & Cardiovascular Systems0.559 SJR (2019) Q2, 166/362 Cardiology and Cardiovascular Medicine, 125/263 Pharmacology (medical)No data IDR 2019UE

An overview of end-of-life issues in a cardiology department. Is the mode of death worse in the cardiac intensive care unit?

Sin financiación2.491 JCR (2019) Q2, 66/138 Cardiac & Cardiovascular Systems; Q3, 30/51 Geriatrics & Gerontology0.696 SJR (2019) Q2, 130/362 Cardiology and Cardiovascular Medicine, 50/109 Geriatrics and GerontologyNo data IDR 2019UE