Cardiogenic shock : incidence, survival and mechanical circulatory support usage 2007-2017-insights from a national registry
© 2020. The Author(s)..
BACKGROUND: A central element in the management of cardiogenic shock (CS) comprises mechanical circulatory support (MCS) systems to maintain cardiac output (CO). This study aims to quantify incidence, outcome and influence of MCS in CS over the last decade.
METHODS: All patients hospitalized with CS in a tertiary university hospital in Germany between 2007 and 2017 were identified utilizing the international coding system ICD-10 with code R57.0. Application of MCS was identified via German procedure classification codes (OPS).
RESULTS: 383,983 cases of cardiogenic shock were reported from 2007 to 2017. Patients had a mean age of 71 years and 38.5% were female. The incidence of CS rose by 65.6% from 26,828 cases in 2007 (33.1 per 100,000 person-years, hospital survival 39.2%) to 44,425 cases in 2017 (53.7 per 100,000 person-years, survival 41.2%). In 2007, 16.0% of patients with CS received MCS (4.6 per 100,000 person-years, survival 46.6%), dropping to 13.9% in 2017 (6.6 per 100,000 person-years, survival 38.6%). Type of MCS changed over the years, with decreasing use of the intra-aortic balloon pump (IABP), an increase in extracorporeal membrane oxygenation (VA-ECMO) and percutaneous ventricular assist device (pVAD) usage. Significant differences regarding in-hospital survival were observed between the devices (survival: overall: 40.2%; medical treatment = 39.5%; IABP = 49.5%; pVAD = 36.2%; VA-ECMO = 30.5%; p < 0.001).
CONCLUSIONS: The incidence of CS is increasing, but hospital survival remains low. MCS was used in a minority of patients, and the percentage of MCS usage in CS has decreased. The use rates of the competing devices change over time.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:110 |
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| Enthalten in: |
Clinical research in cardiology : official journal of the German Cardiac Society - 110(2021), 9 vom: 30. Sept., Seite 1421-1430 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lang, Corinna N [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiogenic shock |
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| Anmerkungen: |
Date Completed 12.01.2022 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00392-020-01781-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318243490 |
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| 100 | 1 | |a Lang, Corinna N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cardiogenic shock |b incidence, survival and mechanical circulatory support usage 2007-2017-insights from a national registry |
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| 500 | |a Date Revised 18.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020. The Author(s). | ||
| 520 | |a BACKGROUND: A central element in the management of cardiogenic shock (CS) comprises mechanical circulatory support (MCS) systems to maintain cardiac output (CO). This study aims to quantify incidence, outcome and influence of MCS in CS over the last decade | ||
| 520 | |a METHODS: All patients hospitalized with CS in a tertiary university hospital in Germany between 2007 and 2017 were identified utilizing the international coding system ICD-10 with code R57.0. Application of MCS was identified via German procedure classification codes (OPS) | ||
| 520 | |a RESULTS: 383,983 cases of cardiogenic shock were reported from 2007 to 2017. Patients had a mean age of 71 years and 38.5% were female. The incidence of CS rose by 65.6% from 26,828 cases in 2007 (33.1 per 100,000 person-years, hospital survival 39.2%) to 44,425 cases in 2017 (53.7 per 100,000 person-years, survival 41.2%). In 2007, 16.0% of patients with CS received MCS (4.6 per 100,000 person-years, survival 46.6%), dropping to 13.9% in 2017 (6.6 per 100,000 person-years, survival 38.6%). Type of MCS changed over the years, with decreasing use of the intra-aortic balloon pump (IABP), an increase in extracorporeal membrane oxygenation (VA-ECMO) and percutaneous ventricular assist device (pVAD) usage. Significant differences regarding in-hospital survival were observed between the devices (survival: overall: 40.2%; medical treatment = 39.5%; IABP = 49.5%; pVAD = 36.2%; VA-ECMO = 30.5%; p < 0.001) | ||
| 520 | |a CONCLUSIONS: The incidence of CS is increasing, but hospital survival remains low. MCS was used in a minority of patients, and the percentage of MCS usage in CS has decreased. The use rates of the competing devices change over time | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiogenic shock | |
| 650 | 4 | |a ECMO | |
| 650 | 4 | |a Mechanical circulatory support | |
| 650 | 4 | |a pVAD | |
| 700 | 1 | |a Kaier, Klaus |e verfasserin |4 aut | |
| 700 | 1 | |a Zotzmann, Viviane |e verfasserin |4 aut | |
| 700 | 1 | |a Stachon, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Pottgiesser, Torben |e verfasserin |4 aut | |
| 700 | 1 | |a von Zur Muehlen, Constantin |e verfasserin |4 aut | |
| 700 | 1 | |a Zehender, Manfred |e verfasserin |4 aut | |
| 700 | 1 | |a Duerschmied, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Schmid, Bonaventura |e verfasserin |4 aut | |
| 700 | 1 | |a Bode, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Wengenmayer, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Staudacher, Dawid L |e verfasserin |4 aut | |
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