Document Detail


Clinical experience with intra-aortic balloon counterpulsation over 10 years: a retrospective cohort study of 459 patients.
MedLine Citation:
PMID:  18314247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sheng-Nan Chang; Juey-Jen Hwang; Yih-Sharng Chen; Jou-Wei Lin; Fu-Tien Chiang
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Publication Detail:
Type:  Journal Article     Date:  2008-03-07
Journal Detail:
Title:  Resuscitation     Volume:  77     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2009-08-11     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  316-24     Citation Subset:  IM    
Affiliation:
Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Female
Humans
Intra-Aortic Balloon Pumping*
Male
Prognosis
Retrospective Studies
Shock, Cardiogenic / mortality,  therapy*
Survival Rate
Time Factors

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


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