| Survival of patients treated with intra-aortic balloon counterpulsation for cardiogenic shock in a tertiary centre: variables correlated with death. | |
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MedLine Citation:
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PMID: 12972898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe the characteristics and mortality rates of 132 cardiogenic shock patients treated with intra-aortic balloon counterpulsation at a university hospital. INTERVENTIONS: All patients underwent intra-aortic balloon counterpulsation. A total of 99 out of 132 patients were revascularized with angioplasty, surgery or were transplanted (intervention group), 33 out of 132 had no further intervention (no-intervention group). MEASUREMENTS AND RESULTS: Overall mortality was 54.5% (72/132). In the intervention group mortality was 50.5% (50/99), in the no-intervention group mortality was 66.6% (22/33). The odds ratio for death comparing the intervention group with the no-intervention group was 0.533 (95% confidence interval 0.238-1.189, P = 0.122). By univariate analysis, diabetes and a left ventricular ejection fraction of less than 0.35 represented an increased odds ratio of death of 4.25 (1.813-9.965, P = 0.001) and 3.03 (1.22-7.54, P = 0.015), respectively. A lactate level greater than 2.5 mg/dl at baseline resulted in an increased odds ratio of death of 5.185 (1.988-13.525, P = 0.0001). Using a multivariate logistic regression analysis, a left ventricular ejection fraction less than 0.35 and diabetes remained significantly correlated with death. CONCLUSION: Mortality rates remain high in cardiogenic shock patients in need of intra-aortic balloon counterpulsation. The odds ratio for death tended to be lower in the intervention group compared with the no-intervention group, although the absolute difference in mortality as a result of an intervention was only 15.2%, and did not reach statistical significance probably because of the small sample size. Diabetes and an ejection fraction lower than 35% are significant predictors for a worse prognosis. |
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Authors:
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Joseph Dens; Christophe Dubois; Hugo Ector; Walter Desmet; Stefan Janssens |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of emergency medicine : official journal of the European Society for Emergency Medicine Volume: 10 ISSN: 0969-9546 ISO Abbreviation: Eur J Emerg Med Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-15 Completed Date: 2004-02-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 213-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B 3000 Leuven, Belgium. Joseph.Dens@uz.kuleuven.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Aged, 80 and over Belgium / epidemiology Cardiac Surgical Procedures / classification, statistics & numerical data Comorbidity Confidence Intervals Diabetes Mellitus / epidemiology Female Heart Failure / epidemiology Hemodynamics Humans Intra-Aortic Balloon Pumping / mortality*, statistics & numerical data Logistic Models Male Middle Aged Multivariate Analysis Myocardial Infarction / classification, epidemiology Myocardial Revascularization Odds Ratio Retrospective Studies Sex Distribution Shock, Cardiogenic / epidemiology*, physiopathology, therapy* Stroke Volume / physiology Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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