Outcomes of Patients with Cancer Admitted with Heart Failure-Associated Cardiogenic Shock.

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Olivia Liu, Steven Soo, Michelle Bloom, Jose Alvarez-Cardona, Jason N Katz, Richard K Cheng, Eric H Yang, Orly Leiva
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引用次数: 0

Abstract

Background: Acute decompensated heart failure (HF) can progress to cardiogenic shock, and patients with cancer are at an increased risk of HF compared to patients without cancer. However, limited data exist on outcomes of patients admitted for HF-related cardiogenic shock (HF-CS) with cancer versus without cancer.

Methods: Adult patients admitted for HF-CS between 2014-2020 were identified using the National Readmission Database. Propensity score matching (PSM) was used to match 1 patient with cancer to 10 patients without cancer. Primary outcomes were in-hospital death, major bleeding, and thrombotic complications. Exploratory outcomes were 90-day readmission rates among patients who survived initial hospitalization. Temporal trends were also explored.

Results: Of 137,316 admissions for HF-CS, 7,306 (5.3%) had active cancer. After PSM, patients with cancer had increased odds of in-hospital death (OR 1.12, 95% CI 1.06 - 1.18), thrombotic complications (OR 1.12, 95% CI 1.03 - 1.21), and major bleeding (OR 1.23, 95% CI 1.17 - 1.31) compared to patients without cancer, with risks differing by cancer type. In exploratory analyses, rates of readmission were similar for patients with and without cancer. From 2014-2020, patients with cancer had no significant change in in-hospital mortality (ptrend = 0.43), while patients without cancer had decreased mortality over time (ptrend < 0.001).

Conclusions: Among patients admitted for HF-CS, patients with cancer are at increased risk of in-hospital death, thrombotic complications, and major bleeding compared to patients without cancer. Future studies are needed to guide nuanced evaluation and management of this population to improve outcomes.

癌症患者合并心力衰竭相关心源性休克的预后
背景:急性失代偿性心力衰竭(HF)可发展为心源性休克,与未患癌症的患者相比,癌症患者发生HF的风险增加。然而,关于hf相关心源性休克(HF-CS)患者的预后,有癌症和无癌症的数据有限。方法:2014-2020年间因HF-CS入院的成年患者使用国家再入院数据库进行识别。使用倾向评分匹配(PSM)将1例癌症患者与10例非癌症患者进行匹配。主要结局是院内死亡、大出血和血栓并发症。探索性结果是首次住院存活患者的90天再入院率。还探讨了时间趋势。结果:在137316例入院的HF-CS患者中,7306例(5.3%)为活动性癌症。PSM后,癌症患者的院内死亡(OR 1.12, 95% CI 1.06 - 1.18)、血栓形成并发症(OR 1.12, 95% CI 1.03 - 1.21)和大出血(OR 1.23, 95% CI 1.17 - 1.31)的几率高于非癌症患者,风险因癌症类型而异。在探索性分析中,癌症患者和非癌症患者的再入院率相似。2014-2020年,癌症患者住院死亡率无显著变化(p趋势= 0.43),而非癌症患者住院死亡率随时间推移而下降(p趋势< 0.001)。结论:在因HF-CS入院的患者中,与没有癌症的患者相比,癌症患者在院内死亡、血栓性并发症和大出血的风险增加。未来的研究需要指导这些人群的细致评估和管理,以改善结果。
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
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
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