Related Experiment Video

Updated: Jun 3, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

3.2K

Utilization of Palliative Care in Cardiogenic Shock Patients: A Retrospective Analysis of the National Inpatient

Akriti Agrawal1, Adishwar Rao1, Ishan Gupta2

  • 1Guthrie Robert Packer Hospital, Sayre, Pennsylvania, USA.

Journal of Palliative Medicine
|January 9, 2025
PubMed

Insights

Palliative care (PC) consultation is underutilized in cardiogenic shock (CS) patients despite higher mortality. PC is more common in older, sicker patients, suggesting preferential use for those nearing death.

Area of Science:

  • Cardiology
  • Palliative Care Medicine
  • Health Services Research

Background:

  • Cardiogenic shock (CS) is a critical condition with high mortality, often resulting from myocardial infarction, myocarditis, or heart failure.
  • The patterns of specialist palliative care (PC) consultation for patients experiencing CS are not well understood.
  • Understanding PC utilization is crucial for improving end-of-life care in this vulnerable population.

Purpose of the Study:

  • To investigate the utilization rates of specialist palliative care (PC) consultations among patients with cardiogenic shock (CS).
  • To analyze the demographic and clinical characteristics, including comorbidities, of CS patients who receive PC evaluations.
  • To compare outcomes, specifically in-hospital mortality, between CS patients with and without PC consultation.

Main Methods:

  • A retrospective analysis of the 2020 National Inpatient Sample database.
  • Identification of 38,531 hospitalizations with cardiogenic shock (ICD-10 CM code R57.0).
  • Comparison of demographics, comorbidities (Charlson Comorbidity Index), hospital stay duration, and mortality between patients receiving PC consultation (ICD-10 CM code Z51.5) and those who did not.

Main Results:

  • Patients receiving PC consultation were older, had shorter hospital stays, and exhibited higher in-hospital mortality rates (65.80% vs. 24.23%).
  • CS patients with PC evaluation had a significantly higher Charlson Comorbidity Index (≥4: 55.22% vs. 48.09%).
  • PC consultation was associated with a six-fold increased odds of in-hospital death (adjusted odds ratio = 6, p < 0.0001).

Conclusions:

  • Specialist palliative care (PC) is not routinely utilized for all patients with cardiogenic shock (CS), despite high mortality rates.
  • PC appears to be preferentially consulted for patients with CS who are more likely to die, indicating a focus on terminal care.
  • Further research is needed to optimize PC consult practices and enhance its utilization for the broader, highly morbid CS patient population.

Keywords:
cardiogenic shockmechanical circulatory supportmortalitynational inpatient samplepalliative care

More Related Videos

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

3.5K
The Intra-Aortic Balloon Pump06:13

The Intra-Aortic Balloon Pump

Published on: February 5, 2021

21.0K

Related Concept Videos

Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
746
Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
758
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
171
Cardiovascular Drugs: Classification based on Therapeutic Indications01:18

Cardiovascular Drugs: Classification based on Therapeutic Indications

Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However,...
2.0K