Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Gerjol, B.
Der Infarkt-assoziierte kardiogene Schock
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 71
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Toth-Gayor Gabor
- von Lewinski Dirk
- Altmetrics:
- Abstract:
- Introduction Cardiovascular diseases are among the most frequent causes of morbidity and mortality. Here, the infarct-associated cardiogenic shock presents a dreaded complication of an acute myocardial infarction, with a mortality rate of ~50% (1). Despite new drug therapies and the development of mechanical circulatory support devices in recent years, study data regarding their efficacy are still sparse and thus require further evaluation. This study aims to identify individual risk factors and prognostic markers for the outcome of patients with infarct-associated cardiogenic shock and to evaluate established therapeutic approaches. Methods In this monocentric retrospective data analysis, a total of 214 patients who received treatment for catecholamine-requiring cardiogenic shock were included and evaluated for duration of hospitalisation, invasive ventilation and duration spend on CCU as well as in-hospital mortality. Patient data were collected using the hospital information system Medocs and the intensive care documentation program PICIS. Results Overall, in-hospital mortality was 43% (n=92). In dependence of the sex, a mortality of 46% (n=71) for men and 35% (n=21) for women was shown, indicating a higher in-hospital mortality of men compared to women (OR=1.6, RR= 1.3, p=0.167). Further, initial pH, CRP values over the first 5 days, initial hemoglobin, initial lactate, and CPR status before admission were shown to be independent prognostic markers. The mortality rate was shown to be 61% (n=72) in the CPR-group, compared to 20% in the no-CPR-group (OR = 5.95, RR = 2.91, p < 0.01). Conclusion Cardiogenic shock remains a major challenge for treating physicians with a high mortality and morbidity. New therapeutic approaches such as mechanical circulatory support systems might help to improve the outcome of patients, but current studies are still sparse and further research is needed to evaluate them.