Document Detail


Causes of death and re-hospitalization in cardiogenic shock.
MedLine Citation:
PMID:  17453536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In cardiogenic shock, causes of death usually are cardiac. However, a systemic inflammatory response syndrome may influence outcome.
METHODS: SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) Trial patients (n = 302) were analyzed regarding cause of death and re-hospitalization.
RESULTS: Deaths (n = 180) occurred < or =30 days in 86% and >30 days in 14%. Known causes of death < or =30 days were cardiac in 88% (37% arrhythmic) and non-cardiac in 12% (29% septic). Non-cardiac deaths < or =30 days occurred later (206 [91,394] versus 41 [15,156] h, P<0.01) and were more frequently associated with signs of inflammation (43 versus 12%, P = 0.01) than cardiac deaths < or =30 days. Known causes of in-hospital death >30 days (n = 19) were cardiac in 58% and non-cardiac in 42%. Among deaths < or =30 days systemic vascular resistance index was higher (2,666+/-1,063 versus 2,090+/-731 dynes.sec.cm(-5) m(2), P = 0.05) than among deaths >30 days. Among the 116 survivors of the initial hospitalization with data available, 52 (45%) were readmitted, most of which due to heart failure (n = 22, 42%) and myocardial ischemia (n = 16, 31%).
CONCLUSIONS: In CS, early deaths < or =30 days are mainly cardiac. Non-cardiac deaths are associated with signs of inflammation. In survivors of the initial hospitalization, re-hospitalizations are due to heart failure and myocardial ischemia.
Authors:
Raban V Jeger; Susan F Assmann; Loran Yehudai; Krishnan Ramanathan; Michael E Farkouh; Judith S Hochman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acute cardiac care     Volume:  9     ISSN:  1748-2941     ISO Abbreviation:  Acute Card Care     Publication Date:  2007  
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-06-13     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  25-33     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Cause of Death*
Coronary Angiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  surgery*
Myocardial Revascularization / methods
Patient Readmission / statistics & numerical data*
Risk Assessment
Risk Factors
Shock, Cardiogenic / etiology*,  mortality*
Statistics, Nonparametric
Survival Analysis
Systemic Inflammatory Response Syndrome / complications*,  etiology,  mortality
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL 49970/HL/NHLBI NIH HHS; HL 50020/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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