Altered mental status predicts mortality in cardiogenic shock -
results from the CardShock study

J 2018

Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study

KATAJA, Anu; Tuukka TARVASMAKI; Johan LASSUS; Lars KOBER; Alessandro SIONIS et al.

Základní údaje

Originální název

Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study

Autoři

Vydání

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, LONDON, SAGE PUBLICATIONS LTD, 2018, 2048-8726

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.734

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/18:00104070

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Cardiogenic shock; acute coronary syndromes; acute heart failure; altered mental status; delirium; acidosis

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 9. 2. 2019 20:17, Soňa Böhmová

Anotace

V originále

Background: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. Methods: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study. Clinical picture, biochemical variables, and short-term mortality were compared between patients presenting with altered and normal mental status. Results: Altered mental status was detected in 147 (68%) patients, whereas 68 (32%) patients had normal mental status. Patients with altered mental status were older (68 vs. 64 years, p=0.04) and more likely to have an acute coronary syndrome than those with normal mental status (85% vs. 74%, p=0.04). Altered mental status was associated with lower systolic blood pressure (76 vs. 80 mmHg, p=0.03) and lower arterial pH (7.27 vs. 7.35, p<0.001) as well as higher levels of blood lactate (3.4 vs. 2.3 mmol/l, p<0.001) and blood glucose (11.4 vs. 9.0 mmol/l, p=0.01). Low arterial pH (adjusted odds ratio 1.6 (1.1-2.2), p=0.02) was the only factor independently associated with altered mental status. Ninety-day mortality was significantly higher (51% vs. 22%, p<0.001) among patients with altered mental status. Conclusions: Altered mental status is a common clinical sign of systemic hypoperfusion in cardiogenic shock and is associated with poor outcome. It is also associated with several biochemical findings that reflect inadequate tissue perfusion, of which low arterial pH is independently associated with altered mental status.

Citovat

KATAJA, Anu; Tuukka TARVASMAKI; Johan LASSUS; Lars KOBER; Alessandro SIONIS; Jindřich ŠPINAR; John PARISSIS; Valentina CARUBELLI; Jose CARDOSO; Marek BANASZEWSKI; Rossella MARINO; Markku S NIEMINEN; Alexandre MEBAZAA a Veli-Pekka HARJOLA. Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE. LONDON: SAGE PUBLICATIONS LTD, 2018, roč. 7, č. 1, s. 38-44. ISSN 2048-8726. Dostupné z: https://doi.org/10.1177/2048872617702505.

@article{1450656,
   author = {Kataja, Anu and Tarvasmaki, Tuukka and Lassus, Johan and Kober, Lars and Sionis, Alessandro and Špinar, Jindřich and Parissis, John and Carubelli, Valentina and Cardoso, Jose and Banaszewski, Marek and Marino, Rossella and Nieminen, Markku S and Mebazaa, Alexandre and Harjola, VeliandPekka},
   article_location = {LONDON},
   article_number = {1},
   doi = {https://doi.org/10.1177/2048872617702505},
   keywords = {Cardiogenic shock; acute coronary syndromes; acute heart failure; altered mental status; delirium; acidosis},
   language = {eng},
   issn = {2048-8726},
   journal = {EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE},
   title = {Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study},
   volume = {7},
   year = {2018}
}

TY  - JOUR
ID  - 1450656
AU  - Kataja, Anu - Tarvasmaki, Tuukka - Lassus, Johan - Kober, Lars - Sionis, Alessandro - Špinar, Jindřich - Parissis, John - Carubelli, Valentina - Cardoso, Jose - Banaszewski, Marek - Marino, Rossella - Nieminen, Markku S - Mebazaa, Alexandre - Harjola, Veli-Pekka
PY  - 2018
TI  - Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study
JF  - EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
VL  - 7
IS  - 1
SP  - 38-44
EP  - 38-44
PB  - SAGE PUBLICATIONS LTD
SN  - 20488726
KW  - Cardiogenic shock
KW  - acute coronary syndromes
KW  - acute heart failure
KW  - altered mental status
KW  - delirium
KW  - acidosis
N2  - Background: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. Methods: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study. Clinical picture, biochemical variables, and short-term mortality were compared between patients presenting with altered and normal mental status. Results: Altered mental status was detected in 147 (68%) patients, whereas 68 (32%) patients had normal mental status. Patients with altered mental status were older (68 vs. 64 years, p=0.04) and more likely to have an acute coronary syndrome than those with normal mental status (85% vs. 74%, p=0.04). Altered mental status was associated with lower systolic blood pressure (76 vs. 80 mmHg, p=0.03) and lower arterial pH (7.27 vs. 7.35, p<0.001) as well as higher levels of blood lactate (3.4 vs. 2.3 mmol/l, p<0.001) and blood glucose (11.4 vs. 9.0 mmol/l, p=0.01). Low arterial pH (adjusted odds ratio 1.6 (1.1-2.2), p=0.02) was the only factor independently associated with altered mental status. Ninety-day mortality was significantly higher (51% vs. 22%, p<0.001) among patients with altered mental status. Conclusions: Altered mental status is a common clinical sign of systemic hypoperfusion in cardiogenic shock and is associated with poor outcome. It is also associated with several biochemical findings that reflect inadequate tissue perfusion, of which low arterial pH is independently associated with altered mental status.
ER  -

KATAJA, Anu; Tuukka TARVASMAKI; Johan LASSUS; Lars KOBER; Alessandro SIONIS; Jindřich ŠPINAR; John PARISSIS; Valentina CARUBELLI; Jose CARDOSO; Marek BANASZEWSKI; Rossella MARINO; Markku S NIEMINEN; Alexandre MEBAZAA a Veli-Pekka HARJOLA. Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study. \textit{EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE}. LONDON: SAGE PUBLICATIONS LTD, 2018, roč.~7, č.~1, s.~38-44. ISSN~2048-8726. Dostupné z: https://doi.org/10.1177/2048872617702505.

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