Abstract
Time From Admission To Right Heart Catheterization In Cardiogenic Shock Patients
Journal of cardiac failure, Vol.29(4), pp.585-585
04/2023
DOI: 10.1016/j.cardfail.2022.10.096
Abstract
Cardiogenic shock (CS) is a complex spectrum of low output states, which can be provoked by Acute Coronary Syndrome (ACS) or Acute Decompensated Heart Failure (ADHF). Its management includes hemodynamic assessment via right heart catheterization (RHC). Contemporary data has demonstrated that the use of RHC in treating patients with CS improves in-hospital mortality. However, the timing of RHC has yet to be fully described. Herein, we describe the timing of RHC based on etiology and severity of CS as defined by the Society of Cardiovascular Angiography & Interventions (SCAI) Shock Classification.
Identification of the average time from admission to invasive hemodynamic evaluation in patients managed for CS secondary to ACS or ADHF.
We performed a single-center retrospective analysis of patients admitted with CS secondary to ACS or ADHF from 7/01/2018 to 6/30/2020 at the University of Iowa Hospitals and Clinics. Patients were identified by the International Classification of Diseases 10th Revision Clinical Modification (ICD-10 CM) codes and were risk-stratified using the SCAI Shock Classification.
Among the 647 patients admitted, 249 patients underwent RHC during their admission. Of those, 51 had underlying ACS and 198 had ADHF. The overall time from admission to invasive hemodynamic assessment was 2.73 days. The mean time for SCAI-A was 3.6 ± 2.8 days, SCAI-B 3.7 ± 3.7 days, SCAI-C 2.6 ± 3.0 days, SCAI-D 2.5 ± 4.1 days, and for SCAI-E 1.3 ± 2.1 days. Patients with underlying ACS had RHC on average of 1.60 days from admission compared with 3.0 days in patients with ADHF (p< 0.01). Among patients admitted with ACS and CS, 70.6% had RHC during the first day as compared to 43.9% of the patients admitted with ADHF and CS (Figure 1). The linear regression model showed that RHC was performed earlier in patients with worse hemodynamics evaluated by Cardiac Power Output (CPO) (Coefficient 0.04, R- squared 0.02, p< 0.01). Hemodynamic parameters showed that high PAPi, RVSWi, and Cardiac Output during admission predicted low in-hospital mortality (p< 0.01).
RHC was performed earlier in more critically ill patients. Patients with CS in the setting of ACS underwent RHC significantly earlier than those with ADHF.
Details
- Title: Subtitle
- Time From Admission To Right Heart Catheterization In Cardiogenic Shock Patients
- Creators
- Ahmed A Abdelhamid - University of IowaMuhammad Umar Khalid - University of IowaRupesh Kshetri - University of IowaAlexandros Briasoulis - Iowa City, IAErnesto Ruiz Duque - University of Iowa, Iowa City, IA
- Resource Type
- Abstract
- Publication Details
- Journal of cardiac failure, Vol.29(4), pp.585-585
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.cardfail.2022.10.096
- ISSN
- 1071-9164
- eISSN
- 1532-8414
- Language
- English
- Date published
- 04/2023
- Academic Unit
- Cardiovascular Medicine; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984388758902771
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