Causes of death and re-hospitalization in cardiogenic shock.
Causes of death and re-hospitalization in cardiogenic shock.
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DOI：
10.1080/17482940601178039
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发表时间：
2007-01-01
期刊：
影响因子：
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通讯作者：
Hochman, Judith S
中科院分区：
文献类型：
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作者：
Jeger, Raban V;Assmann, Susan F;Hochman, Judith S
背景：在心源性休克中，死亡原因通常是心脏的。然而，全身炎症反应综合征可能会影响结果。方法：在心源性休克时，我们是否应该紧急地对闭塞的冠脉进行再血管化？(休克)试验患者(n=302)的死亡原因和再住院情况进行了分析。结果：死亡(n=180)发生在<lt；或=30天占86%，死亡<30天占14%。已知的死亡或死亡30天的原因是心脏病占88%(37%心律失常)，非心脏原因占12%(29%败血症)。非心源性死亡和或=30天后发生(206[91,394]对41[15,156]小时，P30天(n=19)为心源性死亡58%，非心源性死亡42%。在死亡<lt；或=30天组中，全身血管阻力指数(2,666+/-1,063比2,090+/-731 dyne.cm(-5)m(2)，P=0.05)高于死亡<30天组。在首次住院的116名幸存者中，有52人(45%)再次入院，其中大多数是由于心力衰竭(n=22，42%)和心肌缺血(n=16，31%)。结论：在CS中，早期死亡和<30天主要是心脏死亡。非心源性死亡与炎症征兆有关。在初次住院的幸存者中，再次住院的原因是心力衰竭和心肌缺血。
BACKGROUND: In cardiogenic shock, causes of death usually are cardiac. However, a systemic inflammatory response syndrome may influence outcome.METHODS: SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) Trial patients (n = 302) were analyzed regarding cause of death and re-hospitalization.RESULTS: Deaths (n = 180) occurred < or =30 days in 86% and >30 days in 14%. Known causes of death < or =30 days were cardiac in 88% (37% arrhythmic) and non-cardiac in 12% (29% septic). Non-cardiac deaths < or =30 days occurred later (206 [91,394] versus 41 [15,156] h, P30 days (n = 19) were cardiac in 58% and non-cardiac in 42%. Among deaths < or =30 days systemic vascular resistance index was higher (2,666+/-1,063 versus 2,090+/-731 dynes.sec.cm(-5) m(2), P = 0.05) than among deaths >30 days. Among the 116 survivors of the initial hospitalization with data available, 52 (45%) were readmitted, most of which due to heart failure (n = 22, 42%) and myocardial ischemia (n = 16, 31%).CONCLUSIONS: In CS, early deaths < or =30 days are mainly cardiac. Non-cardiac deaths are associated with signs of inflammation. In survivors of the initial hospitalization, re-hospitalizations are due to heart failure and myocardial ischemia.