在心源性休克患者中使用主动脉内球囊泵。

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Bratislava Medical Journal-Bratislavske Lekarske Listy Pub Date : 2024-01-01 DOI:10.4149/BLL_2024_81
Peter Misun, Marek Sramko, Josef Kautzner, Jiri Kettner, Michal Zelizko, Jan Mares, Allan Bohm, Marta Kollarova, Branislav Bezak, Michal Pazdernik
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引用次数: 0

摘要

背景和目的:在过去几年中,人们一直在讨论在心源性休克(CS)中使用主动脉内球囊反搏泵(IABP)的相关性。本研究旨在描述单中心使用 IABP 的 10 年经验,并分析 30 天死亡率的风险因素:这项单中心、观察性、回顾性研究的数据来自 2012 年 1 月至 2022 年 5 月的记录,这些记录涉及在布拉格临床与实验医学研究所急性心脏病学部住院的 CS 患者,他们都接受了 IABP 治疗:在纳入研究的患者中,87%的患者是新发心力衰竭。导致 CS 的主要原因是急性心肌梗死,占 86%。住院死亡率为 39%,30 天死亡率为 43%。经过多变量分析,只有第 5 天的血管活性肌力评分对 30 天死亡率的预测具有统计学意义(P=0.0055)。Cox 回归分析显示,机械并发症是唯一一个对 30 天存活率有显著统计学影响的变量(Log-rank p=0.014,HR 2.19,95% CI:1.15-4.15)。各SCAI级别的30天死亡率在统计学上没有明显差异:结论:CS的主要原因是继发于急性心肌梗死的新发急性心力衰竭。尽管实施了机械循环支持,但院内死亡率和 30 天死亡率仍然很高。血管活性肌力评分的增加和机械并发症的存在被认为是30天存活率的重要预测因素(表6,图1,参考文献36)。Text in PDF www.elis.sk 关键词:心源性休克、IABP、风险因素、死亡率、捷克共和国、AMICS。
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Use of intraaortic balloon pump in cardiogenic shock patients.

Background and objectives: The relevance of the use of intra-aortic balloon pump (IABP) in cardiogenic shock (CS) has been discussed over the past years. The aim of this study is to describe a single-centre 10-year experience with IABP and analyse the risk factors for 30-day mortality.

Methods: The data for this single-centre, observational, retrospective study were drawn from records dated from January 2012 to May 2022 pertaining to patients presenting with CS, treated with IABP and hospitalised at the Department of Acute Cardiology, Institute for Clinical and Experimental Medicine, Prague.

Results: Among the patients included in the study, 87% patients presented with newly developed heart failure. The leading cause of CS was acute myocardial infarction accounting for 86% of cases. Hospital mortality was recorded at 39% and the 30-day mortality reached 43%. Upon multi-variable analysis, only the vasoactive inotropic score on day 5 emerged as a statistically significant predictor for 30-day mortality (p=0.0055). Cox regression analysis revealed that the presence of mechanical complications was the only variable identified as yielding a statistically significant impact on the 30-day survival (Log-rank p=0.014, HR 2.19, 95% CI: 1.15‒4.15). There was no statistically significant difference in the 30-day mortality across the SCAI classes.

Conclusion: The main cause of CS was a newly developed acute heart failure secondary to acute myocardial infarction. Despite the implementation of mechanical circulatory support, both in-hospital and 30-day mortality rates remained high. Increased vasoactive inotropic score and presence of mechanical complications were identified as significant predictors the 30-day survival (Tab. 6, Fig. 1, Ref. 36). Text in PDF www.elis.sk Keywords: cardiogenic shock, IABP, risk factors, mortality, Czech Republic, AMICS.

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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
185
审稿时长
3-8 weeks
期刊介绍: The international biomedical journal - Bratislava Medical Journal – Bratislavske lekarske listy (Bratisl Lek Listy/Bratisl Med J) publishes peer-reviewed articles on all aspects of biomedical sciences, including experimental investigations with clear clinical relevance, original clinical studies and review articles.
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