Long-Term Outcomes of Cardiogenic Shock Complicating Myocardial Infarction
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Cardiogenic shock secondary to acute myocardial infarction (AMI-CS) is associated with substantial short-term mortality; however, there are limited data on long-term outcomes and trends.
OBJECTIVES: This study sought to examine long-term outcomes of AMI-CS patients.
METHODS: This was a population-based, retrospective cohort study in Ontario, Canada of critically ill adult patients with AMI-CS who were admitted to hospitals between April 1, 2009 and March 31, 2019. Outcome data were captured using linked health administrative databases.
RESULTS: A total of 9,789 consecutive patients with AMI-CS from 135 centers were included. The mean age was 70.5 ± 12.3 years, and 67.7% were male. The incidence of AMI-CS was 8.2 per 100,000 person-years, and it increased over the study period. Critical care interventions were common, with 5,422 (55.4%) undergoing invasive mechanical ventilation, 1,425 (14.6%) undergoing renal replacement therapy, and 1,484 (15.2%) receiving mechanical circulatory support. A total of 2,961 patients (30.2%) died in the hospital, and 4,004 (40.9%) died by 1 year. Mortality at 5 years was 58.9%. Small improvements in short- and long-term mortality were seen over the study period. Among survivors to discharge, 2,870 (42.0%) required increased support in care from their preadmission baseline, 3,244 (47.5%) were readmitted to the hospital within 1 year, and 1,047 (15.3%) died within 1 year. The mean number of days at home in the year following discharge was 307.9 ± 109.6.
CONCLUSIONS: Short- and long-term mortality among patients with AMI-CS is high, with minimal improvement over time. AMI-CS survivors experience significant morbidity, with high risks of readmission and death. Future studies should evaluate interventions to minimize postdischarge morbidity and mortality among AMI-CS survivors.
| Errataetall: |
CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):996-998. - PMID 37648358 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
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| Enthalten in: |
Journal of the American College of Cardiology - 82(2023), 10 vom: 05. Sept., Seite 985-995 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sterling, Lee H [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiogenic shock |
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| Anmerkungen: |
Date Completed 01.09.2023 Date Revised 07.09.2023 published: Print CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):996-998. - PMID 37648358 Citation Status MEDLINE |
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| doi: |
10.1016/j.jacc.2023.06.026 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361462204 |
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| 245 | 1 | 0 | |a Long-Term Outcomes of Cardiogenic Shock Complicating Myocardial Infarction |
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| 500 | |a Date Completed 01.09.2023 | ||
| 500 | |a Date Revised 07.09.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: J Am Coll Cardiol. 2023 Sep 5;82(10):996-998. - PMID 37648358 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Cardiogenic shock secondary to acute myocardial infarction (AMI-CS) is associated with substantial short-term mortality; however, there are limited data on long-term outcomes and trends | ||
| 520 | |a OBJECTIVES: This study sought to examine long-term outcomes of AMI-CS patients | ||
| 520 | |a METHODS: This was a population-based, retrospective cohort study in Ontario, Canada of critically ill adult patients with AMI-CS who were admitted to hospitals between April 1, 2009 and March 31, 2019. Outcome data were captured using linked health administrative databases | ||
| 520 | |a RESULTS: A total of 9,789 consecutive patients with AMI-CS from 135 centers were included. The mean age was 70.5 ± 12.3 years, and 67.7% were male. The incidence of AMI-CS was 8.2 per 100,000 person-years, and it increased over the study period. Critical care interventions were common, with 5,422 (55.4%) undergoing invasive mechanical ventilation, 1,425 (14.6%) undergoing renal replacement therapy, and 1,484 (15.2%) receiving mechanical circulatory support. A total of 2,961 patients (30.2%) died in the hospital, and 4,004 (40.9%) died by 1 year. Mortality at 5 years was 58.9%. Small improvements in short- and long-term mortality were seen over the study period. Among survivors to discharge, 2,870 (42.0%) required increased support in care from their preadmission baseline, 3,244 (47.5%) were readmitted to the hospital within 1 year, and 1,047 (15.3%) died within 1 year. The mean number of days at home in the year following discharge was 307.9 ± 109.6 | ||
| 520 | |a CONCLUSIONS: Short- and long-term mortality among patients with AMI-CS is high, with minimal improvement over time. AMI-CS survivors experience significant morbidity, with high risks of readmission and death. Future studies should evaluate interventions to minimize postdischarge morbidity and mortality among AMI-CS survivors | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a cardiogenic shock | |
| 650 | 4 | |a chronic critical illness | |
| 650 | 4 | |a critical care | |
| 650 | 4 | |a long-term outcomes | |
| 650 | 4 | |a post–intensive care syndrome | |
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| 700 | 1 | |a Qureshi, Danial |e verfasserin |4 aut | |
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| 700 | 1 | |a Hibbert, Benjamin |e verfasserin |4 aut | |
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