Multidisciplinary cardiogenic shock team approach improves the long-term outcomes of patients suffering from refractory cardiogenic shock treated with short-term mechanical circulatory support.
HERION, Francois-Xavier
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
Leer más >
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
HERION, Francois-Xavier
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
< Leer menos
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
Idioma
EN
Article de revue
Este ítem está publicado en
European Heart Journal: Acute Cardiovascular Care. 2023-09-15
Resumen en inglés
Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat cardiogenic shock refractory (rCS). However, with growing technical possibilities, making the right choice at the ...Leer más >
Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat cardiogenic shock refractory (rCS). However, with growing technical possibilities, making the right choice at the right time can be challenging. We established a shock team in January 2013 comprising a cardiac anaesthetist-intensivist, an interventional cardiologist, and a cardiac surgeon. Since then, a diagnosis of rCS has triggered a multidisciplinary team meeting based on a common algorithm. This study aimed to compare the decision-making process for STMCS for rCS before (2007-2013) and after (2013-2019) the creation of the shock team. This before-and-after cohort study was conducted over a 156-month period. Post-cardiotomy rCS were excluded. The primary outcome was a 1-year survival rate. In total, 250 consecutive adult patients were included in the analysis (84 in the control group and 166 in the shock team group). At baseline, the CardShock score was not different between the two groups (5[3-5] vs. 5[4-6], p=0.323). The 1-year survival rate was significantly higher in the shock team group compared to the control group (59% vs. 45%, p = 0.043). After a Cox regression analysis, the shock team intervention was independently associated with a significantly improved 1-year survival rate (HR: 0.592, 95% CI: 0.398-0.880, p=0.010). A multidisciplinary shock team-based decision for STMCS device implantation in rCS is associated with better 1-year survival rates.< Leer menos
Palabras clave
Article clinique
Palabras clave en inglés
Life Support; Hospital Rapid Response Team; Multidisciplinary Care Team; Myocardial Infarction; Ventricular Assist Device.
Centros de investigación