心脏重症监护病房收治心源性休克患者的临床特征和结局:一项单中心研究。

IF 3 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Konstantinos C Siaravas, Aidonis Rammos, Aris Bechlioulis, Christos D Floros, Eftychia Papaioannou, Ioanna Samara, Ilektra Stamou, Petros Kalogeras, Spyridon Athanasios Sioros, Vasilis Bouratzis, Lampros Lakkas, Christos S Katsouras, Katerina K Naka, Lampros K Michalis
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引用次数: 0

摘要

背景:心源性休克(CS)是一种以心输出量受损引起的组织灌注不足为特征的危及生命的疾病。尽管在诊断和管理方面取得了进展,但死亡率仍然高得令人无法接受。目的:这项前瞻性、单中心观察性研究旨在描述CS患者的临床特征、管理策略和短期和长期结局。方法:选取某三级大学附属医院心脏重症监护病房(CICU)住院24个月的70例SCAI B-E期患者。收集了人口统计学、临床、血流动力学、超声心动图和生化数据。主要结局为住院死亡率、1个月死亡率和1年死亡率。次要结局包括机械循环支持(MCS)、机械通气(MV)和持续肾替代治疗(CRRT)的使用。结果:急性心肌梗死相关CS (AMI-CS)和心力衰竭相关CS (HF-CS)占64%。住院总死亡率为49%。与b期相比,SCAI C期在所有时间点与更高的死亡率独立相关。死亡率的关键预测因素包括SCAI期升高、乳酸和肌酐水平升高以及心输出量减少。AMI-CS患者更常使用主动脉内球囊泵(IABP)。结论:CS仍然与不良预后相关,特别是在SCAI分期较高的患者中。迫切需要标准化的临床途径和国家登记来指导循证和资源适宜的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Characteristics and Outcomes of Patients Admitted in Cardiac Intensive Care Unit with Cardiogenic Shock: A Single-Center Study.

Background: Cardiogenic shock (CS) is a life threatening condition marked by inadequate tissue perfusion due to impaired cardiac output. Despite advances in diagnosis and management, mortality remains unacceptably high.

Objective: This prospective, single-center observational study aimed to characterize the clinical profile, management strategies, and short- and long-term outcomes of patients with CS.

Methods: Seventy patients (SCAI stages B-E) admitted to the Cardiac Intensive Care Unit (CICU) of a tertiary university hospital over a 24-month period were enrolled. Demographic, clinical, hemodynamic, echocardiographic, and biochemical data were collected. The primary outcomes were in-hospital, 1-month, and 1-year mortality. Secondary outcomes included the use of mechanical circulatory support (MCS), mechanical ventilation (MV), and continuous renal replacement therapy (CRRT).

Results: Acute myocardial infarction-related CS (AMI-CS) and heart failure-related CS (HF-CS) accounted for 64% of cases. The overall in-hospital mortality was 49%. SCAI stage C was independently associated with higher mortality at all time points compared with stage B. Key predictors of mortality included higher SCAI stage, elevated lactate and creatinine levels, and reduced cardiac output. Intra-aortic balloon pump (IABP) use was more frequent in AMI-CS.

Conclusions: CS continues to be associated with poor prognosis, particularly in patients with higher SCAI stages. Standardized clinical pathways and national registries are urgently needed to guide evidence-based and resource-appropriate care.

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