J 2015

Clinical picture and risk prediction of short-term mortality in cardiogenic shock

HARJOLA, Veli-Peka, Johan LASSUS, Alessandro SIONIS, Lars KOBER, Tuukka TARVASMAKI et. al.

Základní údaje

Originální název

Clinical picture and risk prediction of short-term mortality in cardiogenic shock

Autoři

HARJOLA, Veli-Peka (246 Finsko), Johan LASSUS (246 Finsko), Alessandro SIONIS (724 Španělsko), Lars KOBER (208 Dánsko), Tuukka TARVASMAKI (246 Finsko), Jindřich ŠPINAR (203 Česká republika, garant, domácí), John PARISSIS (300 Řecko), Marek BANASZEWSKI (616 Polsko), Jose SILVA-CARDOSO (620 Portugalsko), Valentina CARUBELLI (380 Itálie), Salvatore DI SOMMA (380 Itálie), Heli TOLPPANEN (246 Finsko), Uwe ZEYMER (276 Německo), Holger THIELE (276 Německo), Markku S. NIEMINEN (246 Finsko) a Alexandre MEBAZAA (250 Francie)

Vydání

European Journal of heart Failure, Great Britain, Elsevier Science, 2015, 1388-9842

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 5.135

Kód RIV

RIV/00216224:14110/15:00083511

Organizační jednotka

Lékařská fakulta

UT WoS

000353922100008

Klíčová slova anglicky

Cardiogenic shock; Prognosis; Risk score; Acute myocardial infarction; Acute coronary syndromes; Management

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 4. 8. 2015 14:30, Soňa Böhmová

Anotace

V originále

AimsThe aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. Methods and resultsThe CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute coronary syndrome (ACS) or non-ACS aetiologies were enrolled within 6h from detection of cardiogenic shock defined as severe hypotension with clinical signs of hypoperfusion and/or serum lactate >2mmol/L despite fluid resuscitation (n = 219, mean age 67, 74% men). Data on clinical presentation, management, and biochemical variables were compared between different aetiologies of shock. Systolic blood pressure was on average 78 mmHg (standard deviation 14 mmHg) and mean arterial pressure 57 (11) mmHg. The most common cause (81%) was ACS (68% ST-elevation myocardial infarction and 8% mechanical complications); 94% underwent coronary angiography, of which 89% PCI. Main non-ACS aetiologies were severe chronic heart failure and valvular causes. In-hospital mortality was 37% (n = 80). ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. The CardShock risk Score including these variables and estimated glomerular filtration rate predicted in-hospital mortality well (area under the curve 0.85). ConclusionAlthough most commonly due to ACS, other causes account for one-fifth of cases with shock. ACS is independently associated with in-hospital mortality. The CardShock risk Score, consisting of seven common variables, easily stratifies risk of short-term mortality. It might facilitate early decision-making in intensive care or guide patient selection in clinical trials.