Document Detail


The current practice of intra-aortic balloon counterpulsation: results from the Benchmark Registry.
MedLine Citation:
PMID:  11691523     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study presents clinical data from the first large registry of aortic counterpulsation, a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demographics, concomitant medication and in-hospital outcomes and complications. BACKGROUND: The intra-aortic balloon pump (IABP) is widely used to provide circulatory support for patients experiencing hemodynamic instability due to myocardial infarction, cardiogenic shock, or in very high risk patients undergoing angioplasty or coronary artery bypass grafting. METHODS: Between June 1996 and August 2000, 203 hospitals worldwide (90% U.S., 10% non-U.S.) collected 16,909 patient case records (68.8% men, 31.2% women; mean age 65.9 +/- 11.7 years). RESULTS: The most frequent indications for use of IABP were as follows: to provide hemodynamic support during or after cardiac catheterization (20.6%), cardiogenic shock (18.8%), weaning from cardiopulmonary bypass (16.1%), preoperative use in high risk patients (13.0%) and refractory unstable angina (12.3%). Major IABP complications (major limb ischemia, severe bleeding, balloon leak, death directly due to IABP insertion or failure) occurred in 2.6% of cases; in-hospital mortality was 21.2% (11.6% with the balloon in place). Female gender, high age and peripheral vascular disease were independent predictors of a serious complication. CONCLUSIONS: This registry provides a useful tool for monitoring the evolving practice of IABP. In the modern-day practice of IABP, complication rates are generally low, although in-hospital mortality remains high. There is an increased risk of major complications in women, older patients and patients with peripheral vascular disease.
Authors:
J J Ferguson; M Cohen; R J Freedman; G W Stone; M F Miller; D L Joseph; E M Ohman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  38     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1456-62     Citation Subset:  AIM; IM    
Affiliation:
Texas Heart Institute, Houston, Texas 77030, USA. jferguson@heart.thi.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Angina, Unstable / therapy
Benchmarking / organization & administration*
Cardiopulmonary Bypass
Coronary Artery Bypass
Data Collection / methods
Female
Guideline Adherence / standards,  statistics & numerical data
Heart Catheterization
Hospital Mortality
Humans
Intra-Aortic Balloon Pumping / adverse effects,  mortality,  standards*,  statistics & numerical data*
Male
Middle Aged
Patient Selection
Physician's Practice Patterns / standards*,  statistics & numerical data
Practice Guidelines as Topic / standards
Predictive Value of Tests
Prospective Studies
Registries*
Risk Factors
Shock, Cardiogenic / therapy
Treatment Outcome

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