Clinical outcomes of cardiogenic shock among critically ill patients admitted to intensive care units in Australia and New Zealand from 2003 to 2022

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2024-12-16 DOI:10.1016/j.jcrc.2024.155001

Wisam Al-Bassam , Samer Noaman , Rahul Kumar , Neil Glassford , Daryl Jones , Carys Jones , William Chan , David M. Kaye , David Pilcher , Rinaldo Bellomo , Yehya shehabi , Ary Serpa Neto

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引用次数: 0

Abstract

Purpose

Patients with Cardiogenic shock (CS) admitted to intensive care units (ICUs) have high mortality rates. We aimed to investigate the changes patient characteristics and outcomes over time among patients admitted to the ICU with CS.

Methods

Retrospective study utilizing a large bi-national ICU database from 2003 to 2022. Patient characteristics and outcomes based on the ICU admission diagnosis of CS were evaluated and changes in outcomes over time after adjusting for key baseline variables were assessed.

Results

During the study period, among CS patients, there were significant reductions in severity of illness (APACHE III from 80 to 72 and Australian and New Zealand Risk of Death Scores from 0.34 to 0.30, both p < 0.001). There was also a significant increase in admissions from emergency departments (32 % to 41 %, p < 0.001). Over time, unadjusted hospital mortality decreased from 57 % in 2003 to 41 % in 2022 (P < 0.001). After adjustment for severity of illness, the odds ratios for hospital mortality also decreased to 0.49 (95 % CI, 0.38 to 0.64) compared with 2003 (p < 0.001).

Conclusions

Over twenty years period, among patients with CS admitted to ICU, there has been a significant change in the epidemiological characteristics and a decrease in absolute and adjusted mortality rates.

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2003年至2022年澳大利亚和新西兰重症监护病房危重患者心源性休克的临床结果

目的：入住重症监护病房（icu）的心源性休克（CS）患者死亡率高。我们的目的是调查入住ICU的CS患者的特征和结果随时间的变化。方法：回顾性研究利用2003 - 2022年大型两国ICU数据库。评估基于CS的ICU入院诊断的患者特征和结局，并评估调整关键基线变量后结局随时间的变化。结果：在研究期间，CS患者的病情严重程度显著降低(APACHE III评分从80降至72，澳大利亚和新西兰死亡风险评分从0.34降至0.30，均为p。结论：20多年来，ICU收治的CS患者的流行病学特征发生了显著变化，绝对死亡率和调整死亡率均有所下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.