Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality

Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in‐hospital outcomes in patients who received IHM versus no IHM in a real‐world contemporary databas...

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Autores principales:	Mohammed Osman, Moinuddin Syed, Brijesh Patel, Muhammad Bilal Munir, Babikir Kheiri, Marco Caccamo, George Sokos, Sudarshan Balla, Mir Babar Basir, Navin K. Kapur, Mamas A. Mamas, Christopher M. Bianco
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	cardiogenic shock invasive hemodynamic pulmonary arterial catheter Swan‐Ganz catheter Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f968e6c89e254a2eb9a9563e9344342d
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spelling	oai:doaj.org-article:f968e6c89e254a2eb9a9563e9344342d2021-11-23T11:36:35ZInvasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality10.1161/JAHA.121.0218082047-9980https://doaj.org/article/f968e6c89e254a2eb9a9563e9344342d2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021808https://doaj.org/toc/2047-9980Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in‐hospital outcomes in patients who received IHM versus no IHM in a real‐world contemporary database. Methods and Results Patients with cardiogenic shock admitted during October 1, 2015 to December 31, 2018, were identified from the National Inpatient Sample. Among this group, we compared the outcomes among patients who received IHM versus no IHM. The primary end point was in‐hospital mortality. Secondary end points included vascular complications, major bleeding, need for renal replacement therapy, length of stay, cost of hospitalization, and rate of utilization of left ventricular assist devices and heart transplantation. Propensity score matching was used for covariate adjustment. A total of 394 635 (IHM=62 565; no IHM=332 070) patients were included. After propensity score matching, 2 well‐matched groups were compared (IHM=62 220; no IHM=62 220). The IHM group had lower in‐hospital mortality (24.1% versus 30.6%, P<0.01), higher percentages of left ventricular assist devices (4.4% versus 1.3%, P<0.01) and heart transplantation (1.3% versus 0.7%, P<0.01) utilization, longer length of hospitalization and higher costs. There was no difference between the 2 groups in terms of vascular complications, major bleeding, and the need for renal replacement therapy. Conclusions Among patients with cardiogenic shock, the use of IHM is associated with a reduction in in‐hospital mortality and increased utilization of advanced heart failure therapies. Due to the observational nature of the current study, the results should be considered hypothesis‐generating, and future prospective studies confirming these findings are needed.Mohammed OsmanMoinuddin SyedBrijesh PatelMuhammad Bilal MunirBabikir KheiriMarco CaccamoGeorge SokosSudarshan BallaMir Babar BasirNavin K. KapurMamas A. MamasChristopher M. BiancoWileyarticlecardiogenic shockinvasive hemodynamicpulmonary arterial catheterSwan‐Ganz catheterDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiogenic shock invasive hemodynamic pulmonary arterial catheter Swan‐Ganz catheter Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiogenic shock invasive hemodynamic pulmonary arterial catheter Swan‐Ganz catheter Diseases of the circulatory (Cardiovascular) system RC666-701 Mohammed Osman Moinuddin Syed Brijesh Patel Muhammad Bilal Munir Babikir Kheiri Marco Caccamo George Sokos Sudarshan Balla Mir Babar Basir Navin K. Kapur Mamas A. Mamas Christopher M. Bianco Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
description	Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in‐hospital outcomes in patients who received IHM versus no IHM in a real‐world contemporary database. Methods and Results Patients with cardiogenic shock admitted during October 1, 2015 to December 31, 2018, were identified from the National Inpatient Sample. Among this group, we compared the outcomes among patients who received IHM versus no IHM. The primary end point was in‐hospital mortality. Secondary end points included vascular complications, major bleeding, need for renal replacement therapy, length of stay, cost of hospitalization, and rate of utilization of left ventricular assist devices and heart transplantation. Propensity score matching was used for covariate adjustment. A total of 394 635 (IHM=62 565; no IHM=332 070) patients were included. After propensity score matching, 2 well‐matched groups were compared (IHM=62 220; no IHM=62 220). The IHM group had lower in‐hospital mortality (24.1% versus 30.6%, P<0.01), higher percentages of left ventricular assist devices (4.4% versus 1.3%, P<0.01) and heart transplantation (1.3% versus 0.7%, P<0.01) utilization, longer length of hospitalization and higher costs. There was no difference between the 2 groups in terms of vascular complications, major bleeding, and the need for renal replacement therapy. Conclusions Among patients with cardiogenic shock, the use of IHM is associated with a reduction in in‐hospital mortality and increased utilization of advanced heart failure therapies. Due to the observational nature of the current study, the results should be considered hypothesis‐generating, and future prospective studies confirming these findings are needed.
format	article
author	Mohammed Osman Moinuddin Syed Brijesh Patel Muhammad Bilal Munir Babikir Kheiri Marco Caccamo George Sokos Sudarshan Balla Mir Babar Basir Navin K. Kapur Mamas A. Mamas Christopher M. Bianco
author_facet	Mohammed Osman Moinuddin Syed Brijesh Patel Muhammad Bilal Munir Babikir Kheiri Marco Caccamo George Sokos Sudarshan Balla Mir Babar Basir Navin K. Kapur Mamas A. Mamas Christopher M. Bianco
author_sort	Mohammed Osman
title	Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
title_short	Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
title_full	Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
title_fullStr	Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
title_full_unstemmed	Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality
title_sort	invasive hemodynamic monitoring in cardiogenic shock is associated with lower in‐hospital mortality
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/f968e6c89e254a2eb9a9563e9344342d
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Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In‐Hospital Mortality

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