Impact of the spleen size on short-term prognosis in patients with cardiogenic shock receiving Impella-incorporated temporary mechanical circulatory support

Abstract

The spleen size may be associated with mortality and morbidity in patients with heart failure, whereas its clinical implication in patients with cardiogenic shock receiving Impella-incorporated temporary mechanical circulatory support (MCS) remains unknown. Patients who received Impella-incorporated temporary MCS in our institute between March 2018 and August 2023 were eligible. The splenic volume index (SVI) was retrospectively calculated in all participants by measuring spleen size on the computed tomography obtained at the time of Impella placement. The impact of baseline SVI/central venous pressure (CVP) ratio on the 30-day mortality after Impella placement was evaluated. A total of 74 patients (70 years old, 62% men) were included. Median baseline SVI was 71.6 (50.3, 92.1) mL/m². A lower SVI was associated with more decreased cardiac output and a higher SVI was associated with more elevated CVP (p < 0.05 for both). A lower SVI/CVP ratio was associated with higher 30-day mortality with an adjusted hazard ratio of 3.734 (95% confidence interval 1.397–9.981, p = 0.009). A baseline lower SVI/CVP ratio was associated with short-term mortality in patients receiving Impella-incorporated temporary MCS.