Author + information
- Gursukhmandeep Sidhu1,
- Samir Pancholy2,
- Anurag Bajaj3,
- Qasim Malik4,
- Sukrut Nanavaty5,
- Arpit Sothwal6 and
- Gaurav Patel4
- 1The wright center for graduate medical education, Scranton, Pennsylvania, United States
- 2The Wright Center For Graduate Medical Education., Scranton, Pennsylvania, United States
- 3The wright center for graduate medical education, scranton, Pennsylvania, United States
- 4The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
- 5The Wright Center For Graduate Medical Education, Scranton, Pennsylvania, United States
- 6The Wright Center, scranton, Pennsylvania, United States
Pulmonary artery catheterization(PAC) is an option in cardiogenic shock(CS) patients for rapid diagnosis and to direct mechanical and pharmacological support. We evaluated contemporary outcomes of PAC in patients with CS.
Subjects were obtained from the national inpatient sample database. ICD-9-CM procedure codes were used to identify all patients with a diagnosis of CS(ICD9 785.51) who received PAC between years 2010-2014. Propensity score matching was used to adjust for baseline confounders.
Among 106258 patients with CS, 7440(7%) received a PAC. 15.5% of patients with congestive heart failure(CHF) and CS received PAC compared to 6% of patients with acute myocardial infarction(AMI) and CS. A decrease in hospital mortality rate was observed in in patients receiving PAC (unmatched 37.4% vs. 30.3%, p<0.001, and matched 34.8% vs. 30.3%, P<0.001). On subgroup analysis, no mortality difference was observed in AMI CS. A higher incidence of pneumothorax was observed. Length of stay and total hospital costs were higher in the PAC group.
Patients who develop CS who receive PAC may have reduced in-hospital all-cause mortality, which may come with associated increase in length of stay and hospitalization costs.
CORONARY: Hemodynamic Support and Cardiogenic Shock