Document Detail


Survival of patients treated with intra-aortic balloon counterpulsation for cardiogenic shock in a tertiary centre: variables correlated with death.
MedLine Citation:
PMID:  12972898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Joseph Dens; Christophe Dubois; Hugo Ector; Walter Desmet; Stefan Janssens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2003-09-15     Completed Date:  2004-02-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  213-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B 3000 Leuven, Belgium. Joseph.Dens@uz.kuleuven.ac.be
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MeSH Terms
Descriptor/Qualifier:
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

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