Journal article
Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock
Journal of cardiac failure, v 29(9), pp 1234-1244
01 Sep 2023
PMID: 37187230
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS).
This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50–0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37–0.81).
This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission.
An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50–0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37–0.81).
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Details
- Title
- Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock
- Creators
- MANREET K. Kanwar - Allegheny Health NetworkVANESSA Blumer - Cleveland ClinicYIJING Zhang - Tufts Medical CenterSHASHANK S. Sinha - Inova Fairfax HospitalARTHUR R. Garan - Beth Israel Deaconess Medical CenterJAIME HERNANDEZ-MONTFORT - Baylor Scott & White HealthADNAN Khalif - Allegheny Health NetworkGAVIN W. Hickey - University of Pittsburgh Medical CenterJACOB Abraham - Hope Heart InstituteCLAUDIUS Mahr - University of Washington Medical CenterBORUI LI - Tufts Medical CenterPAAVNI Sangal - Tufts Medical CenterKAROL D. Walec - Tufts Medical CenterPETER Zazzali - Tufts Medical CenterRACHNA Kataria - LifespanMOHIT Pahuja - University of Oklahoma Health Sciences CenterVAN-KHUE Ton - Massachusetts General HospitalNEIL M. Harwani - Tufts Medical CenterDETLEF Wencker - Baylor Scott & White HealthSANDEEP Nathan - University of ChicagoESTHER Vorovich - Northwestern MedicineSHELLEY Hall - Baylor Scott & White HealthWISSAM Khalife - The University of Texas Medical Branch at GalvestonSONG LI - University of Washington Medical CenterANDREW Schwartzman - Maine Medical CenterJ U Kim - Houston MethodistOLEG ALEC Vishnevsky - Thomas Jefferson University HospitalLUDOVIC Trinquart - Tufts Medical CenterDANIEL Burkhoff - Cardiovascular Research FoundationNAVIN K. Kapur - Tufts Medical Center
- Publication Details
- Journal of cardiac failure, v 29(9), pp 1234-1244
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:001081561000001
- Scopus ID
- 2-s2.0-85161033383
- Other Identifier
- 991021932191404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems