Clinical profile, management and outcomes of patients with cardiogenic shock undergoing transfer between centers in Spain.
Rev Esp Cardiol (Engl Ed)
; 77(3): 226-233, 2024 Mar.
Article
em En, Es
| MEDLINE
| ID: mdl-37925017
ABSTRACT
INTRODUCTION AND OBJECTIVES:
The aim of this study was to analyze the clinical profile, management, and prognosis of ST segment elevation myocardial infarction-related cardiogenic shock (STEMI-CS) requiring interhospital transfer, as well as the prognostic impact of structural variables of the treating centers in this setting.METHODS:
This study included patients with STEMI-CS treated at revascularization-capable centers from 2016 to 2020. The patients were divided into the following groups group A patients attended throughout their admission at hospitals with interventional cardiology without cardiac surgery; group B patients treated at hospitals with interventional cardiology and cardiac surgery; and group C patients transferred to centers with interventional cardiology and cardiac surgery. We analyzed the association between the volume of STEMI-CS cases treated, the availability of cardiac intensive care units (CICU), and heart transplant with hospital mortality.RESULTS:
A total of 4189 episodes were included 1389 (33.2%) from group A, 2627 from group B (62.7%), and 173 from group C (4.1%). Transferred patients were younger, had a higher cardiovascular risk, and more commonly underwent revascularization, mechanical circulatory support, and heart transplant during hospitalization (P<.001). The crude mortality rate was lower in transferred patients (46.2% vs 60.3% in group A and 54.4% in group B, (P<.001)). Lower mortality was associated with a higher volume of care and CICU availability (OR, 0.75, P=.009; and 0.80, P=.047).CONCLUSIONS:
The proportion of transfers in patients with STEMI-CS in our setting is low. Transferred patients were younger and underwent more invasive procedures. Mortality was lower among patients transferred to centers with a higher volume of STEMI-CS cases and CICU.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Intervenção Coronária Percutânea
/
Infarto do Miocárdio com Supradesnível do Segmento ST
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Espanha