Clinical characteristics and survival in cardiogenic shock admissions to a UK heart transplant unit

Future Cardiol. 2018 Sep;14(5):397-406. doi: 10.2217/fca-2017-0094. Epub 2018 Sep 20.

Abstract

Aim: We describe the characteristics and outcomes of cardiogenic shock (CS) admissions to a UK transplant unit, which is previously unreported.

Patients & methods: Fifty-nine unselected, consecutive patients over a 38-month period in CS (INTERMACS ≤2) and potentially eligible for transplant were retrospectively reviewed.

Results: Patients were predominantly male (76.3%), young (mean age 42.2 years) and with severe end-organ dysfunction (acute liver/kidney injury 83%, mean lactate 3.5 mmol/l). 57.6% required mechanical support and 28.8% cardiac transplant. 30 days, discharge and 1-year survival were 78, 68 and 63%, respectively. Predictors of death included no transplant, increasing age and increasing creatinine.

Conclusion: Patients with CS and potential for transplant require significant resource input but demonstrate favorable outcomes in our experience.

Keywords: cardiogenic shock; extracorporeal membrane oxygenation; heart failure; inotropes; intra-aortic balloon pump; mechanical circulatory support; transplantation; ventricular assist device.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cause of Death
  • Cohort Studies
  • Critical Illness
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Follow-Up Studies
  • Heart Transplantation / methods*
  • Heart-Assist Devices / statistics & numerical data*
  • Hospital Mortality*
  • Humans
  • Intra-Aortic Balloon Pumping
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Admission / statistics & numerical data
  • Patient Selection
  • Proportional Hazards Models
  • Retrospective Studies
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / mortality*
  • Shock, Cardiogenic / therapy*
  • Survival Analysis
  • United Kingdom