Prognostic Value of Neurological Status on Hospital Arrival for Short-Term Outcome in Patients With Cardiovascular Shockã- Sub-analysis of the Japanese Circulation Society Cardiovascular Shock Registry.
Circ J
; 83(6): 1247-1253, 2019 05 24.
Article
em En
| MEDLINE
| ID: mdl-30944275
ABSTRACT
BACKGROUND:
Consciousness disturbance is one of the major clinical signs associated with shock state, but its prognostic value has not been previously evaluated in cardiovascular shock patients. We aimed to evaluate the prognostic value of neurological status for 30-day mortality in cardiovascular shock patients without out-of-hospital cardiac arrest (OHCA). MethodsâandâResults:
Patients with out-of-hospital onset cardiovascular shock were recruited from the Japanese Circulation Society Shock Registry. Neurological status upon hospital arrival was evaluated using the Japan Coma Scale (JCS). Patients were divided into 4 groups according to the JCS alert, JCS 0; awake, JCS 1-3 (not fully alert but awake without any stimuli); arousable, JCS 10-30 (arousable with stimulation); and coma JCS 100-300 (unarousable). The primary endpoint was 30-day all-cause death. In total, 700 cardiovascular shock patients without OHCA were assessed. The coma group was associated with a higher incidence of 30-day all-cause death compared with other groups (alert, 15.3%; awake, 24.4%; arousable, 36.8%; coma, 48.5%, P<0.001). Similar trends were observed in etiologically divergent subgroups (acute coronary syndrome, non-ischemic arrhythmia, and aortic disease). On multivariate Cox regression analysis, arousable (hazard ratio [HR], 1.82; 95% CI 1.16-2.85, P=0.009) and coma (HR, 2.72; 95% CI 1.76-4.22, P<0.001) (reference alert) independently predicted 30-day mortality.CONCLUSIONS:
Neurological status upon hospital arrival was useful to predict 30-day mortality in cardiovascular shock patients without OHCA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Cardiogênico
/
Parada Cardíaca Extra-Hospitalar
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Female
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Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article