| Clinical experience with intra-aortic balloon counterpulsation over 10 years: a retrospective cohort study of 459 patients. | |
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MedLine Citation:
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PMID: 18314247 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to identify prognostic predictors for the patients experiencing cardiogenic shock who required the institution of intra-aortic balloon counterpulsation (IABP). DESIGN, SETTING, AND PATIENTS: Patients with cardiogenic shock were retrieved from the clinical information system in National Taiwan University Hospital and classified according to their etiology: acute coronary syndrome (ACS), ST segment elevation myocardial infarction (STEMI), congestive heart failure (CHF), hemodynamic instability after post-coronary bypass graft operation (post-CABG) or after percutaneous intervention (post-PCI), and out-of-hospital cardiac arrest (OHCA) victims. MEASUREMENTS: Kaplan-Meier curves and Cox regression model were applied to evaluate the factors associated with survival. MAIN RESULTS: A total of 459 patients were found to belong to one of six etiology categories between 1995 and 2004. The 30-day mortality was highest in the OHCA group, followed by the STEMI, CHF, ACS, post-PCI, and post-CABG groups in a decreasing frequency (log rank p<0.001). Peak troponin I level was negatively associated with survival, and its effect largely paralleled with underlying etiology. Age and renal impairment were significant prognostic predictors for 30-day mortality (hazard ratio=1.031, p<0.001 and hazard ratio=1.266, p<0.001). Comparing to those manifested as OHCA who had the worst outcome, patients in the other etiology groups had significantly better survival. CONCLUSIONS: This study has illustrated that age, renal function, and etiology-related cardiac injury are predictors for in-hospital course and mortality in those who experienced cardiogenic shock with IABP. The optimal strategy for revascularization in this high-risk group needs further validation. |
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Authors:
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Sheng-Nan Chang; Juey-Jen Hwang; Yih-Sharng Chen; Jou-Wei Lin; Fu-Tien Chiang |
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Publication Detail:
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Type: Journal Article Date: 2008-03-07 |
Journal Detail:
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Title: Resuscitation Volume: 77 ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-19 Completed Date: 2009-08-11 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 316-24 Citation Subset: IM |
Affiliation:
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Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cohort Studies Female Humans Intra-Aortic Balloon Pumping* Male Prognosis Retrospective Studies Shock, Cardiogenic / mortality, therapy* Survival Rate Time Factors |
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