Causes of death and re‐hospitalization in cardiogenic shock

Abstract

Background: In cardiogenic shock, causes of death usually are cardiac. However, a systemic inflammatory response syndrome may influence outcome. Methods: SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) Trial patients (n = 302) were analyzed regarding cause of death and re‐hospitalization. Results: Deaths (n = 180) occurred ⩽30 days in 86% and >30 days in 14%. Known causes of death ⩽30 days were cardiac in 88% (37% arrhythmic) and non‐cardiac in 12% (29% septic). Non‐cardiac deaths ⩽30 days occurred later (206 [91,394] versus 41 [15,156] h, P<0.01) and were more frequently associated with signs of inflammation (43 versus 12%, P = 0.01) than cardiac deaths ⩽30 days. Known causes of in‐hospital death >30 days (n = 19) were cardiac in 58% and non‐cardiac in 42%. Among deaths ⩽30 days systemic vascular resistance index was higher (2,666±1,063 versus 2,090±731 dynes·sec·cm⁻⁵ m², P = 0.05) than among deaths >30 days. Among the 116 survivors of the initial hospitalization with data available, 52 (45%) were readmitted, most of which due to heart failure (n = 22, 42%) and myocardial ischemia (n = 16, 31%). Conclusions: In CS, early deaths ⩽30 days are mainly cardiac. Non‐cardiac deaths are associated with signs of inflammation. In survivors of the initial hospitalization, re‐hospitalizations are due to heart failure and myocardial ischemia.

• Cardiogenic shock
• cause of death
• arrhythmia
• sepsis syndrome
• hospitalization