The goal of this observational study is to understand and describe the epidemiology of cardiogenic shock in Emilia Romagna with a specific focus on outcome stratified by aetiologies, sex and age. The main outcomes are: * Incidence of cardiogenic shock (CS) over the total CICU admissions, CS-related in-hospital mortality and length of hospitalization, stratified by aetiologies, sex and age * Epidemiology of patients admitted with CS, regarding age, gender, etiology and modality of presentation (acute or acute on chronic), echocardiographic and haemodynamic data, treatment strategy with inotropes and/or short-term MCS, cardiac arrest. This is an observational study without intervention. Patients will be treated according to current clinical practice, according to physician judgment and data sheets of each drug used according to clinical practice.
This is a multicenter observational study with both a retrospective and a prospective cohort. Study population will include all consecutive patients diagnosed with cardiogenic shock and admitted to the cardiac intensive care unit of the participating centers. For the patients enrolled at IRCCS Azienda Ospedaliera-Universitaria di Bologna this study will involve a collaboration with UO Cardiologia. For the retrospective cohort, patients will be selected based on ICD9 discharge codes and included if they fulfill inclusion criteria after review of hospital charts. The retrospective cohort will serve as a historical comparison regarding epidemiology, treatment strategies and survival. Incidence and workload burden of CICU will be studied comparing the number of CS patients and the total number of admissions in the study period.
Study Type
OBSERVATIONAL
Enrollment
500
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Bologna, Bologna, Italy
RECRUITINGIncidence of CS over the total CICU admissions stratified by aetiologies, sex and age.
Incidence
Time frame: 5 years
Length of hospitalization, stratified by aetiologies, sex and age.
Days
Time frame: 5 years
CS-related in-hospital mortality stratified by aetiologies, sex and age.
Incidence
Time frame: 5 years
Epidemiology of patients admitted with CS, regarding age, gender, etiology and modality of presentation (acute or acute on chronic), echocardiographic and haemodynamic data, treatment strategy with inotropes and/or short-term MCS, cardiac arrest.
Demography description
Time frame: 5 years
Recovery from cardiogenic shock, defined as improvement to at least SCAI stage B or discharge from CICU to a step-down ward
Recovery from cardiogenic shock
Time frame: 5 years
In-hospital survival according to age, etiology, presentation (acute or acute on chronic) and modality of treatment (inotropes or MCS).
In-hospital survival
Time frame: 5 years
Rate and reason of unplanned re-hospitalizations within one month after primary discharge
Rate and reason of unplanned re-hospitalizations
Time frame: 5 years
Workload burden will be estimated as the percentage of CS admission and the mean duration of CICU stay as compared to other admissions during study period
Workload burden
Time frame: 5 years
Rate of adherence to several items and differences between older era (retrospective data) and prospective cohort
Blood counts, ECG, oxygen saturation and respiratory monitoring.
Time frame: 5 years
Rate of successful bridge to heart replacement therapy (heart transplant or LVAD implant) in patients potentially eligible (i.e. age < 71 years old) and transferred to IRCCS Policlinico S.Orsola hub center.
Rate of successful bridge to heart replacement therapy
Time frame: 5 years
Comparison of survival between patients who underwent HRT as a consequence of CS to elective patients in the study period
Comparison of survival
Time frame: 5 years
Description of in-hospital complications such as rate of renal replacement therapy, number of nosocomial infections with therapy and consequent associated mortality.
Description of in-hospital complications
Time frame: 5 years
Description of MCS-related complications, including bleeding requiring transfusions, vascular complications including bleeding requiring intervention and limb ischemia.
Description of MCS-related complications
Time frame: 5 years
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