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
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Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
HERION, Francois-Xavier
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
< Réduire
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
Langue
EN
Article de revue
Ce document a été publié dans
European Heart Journal: Acute Cardiovascular Care. 2023-09-15
Résumé en anglais
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 ...Lire la suite >
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.< Réduire
Mots clés
Article clinique
Mots clés en anglais
Life Support; Hospital Rapid Response Team; Multidisciplinary Care Team; Myocardial Infarction; Ventricular Assist Device.
Unités de recherche