Clinical outcomes of cardiogenic shock among critically ill patients admitted to intensive care units in Australia and New Zealand from 2003 to 2022

Purpose

Patients with Cardiogenic shock (CS) admitted to intensive care units (ICUs) have high mortality rates. We aimed to investigate the changes patient characteristics and outcomes over time among patients admitted to the ICU with CS.

Methods

Retrospective study utilizing a large bi-national ICU database from 2003 to 2022. Patient characteristics and outcomes based on the ICU admission diagnosis of CS were evaluated and changes in outcomes over time after adjusting for key baseline variables were assessed.

Results

During the study period, among CS patients, there were significant reductions in severity of illness (APACHE III from 80 to 72 and Australian and New Zealand Risk of Death Scores from 0.34 to 0.30, both p < 0.001). There was also a significant increase in admissions from emergency departments (32 % to 41 %, p < 0.001). Over time, unadjusted hospital mortality decreased from 57 % in 2003 to 41 % in 2022 (P < 0.001). After adjustment for severity of illness, the odds ratios for hospital mortality also decreased to 0.49 (95 % CI, 0.38 to 0.64) compared with 2003 (p < 0.001).

Conclusions

Over twenty years period, among patients with CS admitted to ICU, there has been a significant change in the epidemiological characteristics and a decrease in absolute and adjusted mortality rates.