Six-month outcomes in patients with cardiogenic shock: insights from a single-center Shock Team experience
M Blaziak, R P Przybylski, W G Gozdzik, M Z Zakliczynski, B B G Barteczko-Grajek, M B Bochenek, M S Sokolski, R Z Zymlinski, J B Biegus, W Z Zimoch, M K Kosowski, P K Kubler, K R Reczuch, P P Ponikowski, W K KuliczkowskiAbstract
Background
Registry-based analyses have consistently demonstrated that dedicated Shock Teams can improve in-hospital outcomes; however, evidence regarding post-discharge survival remains limited.
Aims
We sought to evaluate mid-term outcomes among survivors of cardiogenic shock (CS).
Methods
This single-center observational study, conducted at a high-volume tertiary care hospital, included both retrospective and prospective cohorts of patients hospitalized for CS between January 2021 and December 2024. The primary endpoint was all-cause mortality at 180 days post-hospitalization. The secondary endpoint was all-cause in-hospital mortality.
Results
Over the four-year study period, 346 consecutive patients with CS were managed. Acute coronary syndrome was the predominant cause (59%) of CS, followed by acute decompensated heart failure (28%), and other etiologies accounting for the remaining 13%. Mechanical circulatory support (MCS) was utilized in 154 patients (44.5%), increasing from 46.8% in 2021 to 60.7% in 2024 (p < 0.01). Overall, survival to hospital discharge was 45.4% and 180-day survival was 38.2%. Among patients receiving MCS, 180-day mortality was 49.4%, decreasing from 77.8% in 2021 to 37.1% in 2024 (p < 0.01). In-hospital mortality decreased similarly from 75.3% in 2021 to 31.2% in 2024 (p < 0.01). A total of 34 patients (9.8%) underwent heart transplantation, and 22 patients (6.4%) received left ventricular assist device (LVAD) therapy. Native heart survival was observed in 76 patients (30.0%) in the overall population. Multivariate logistic regression analysis identified MCS use as an independent predictor of improved 180-day survival (OR 0.56, 95% CI 0.31–0.98; p = 0.04).
Conclusions
In our study, MCS use was independently associated with enhanced survival to discharge, extending out to 180 days. However, one in ten patients died within the first months after discharge, highlighting the vulnerability of this time.For image description, please refer to the figure legend and surrounding text.