心脏性休克的流行病学使用休克学术研究联盟 (SHARC) 的共识定义
David D Berg1, Erin A Bohula1, Siddharth M Patel1
1Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA 02115, USA.
European heart journal. Acute cardiovascular care
|August 29, 2024
概括
冲击学术研究联盟 (SHARC) 对心脏性冲击 (CS) 的定义确定了具有不同结果的不同患者群体. 将这些定义应用于心脏重症监护病房,揭示了CS亚群的死亡率和治疗需求的差异.
科学领域:
- 心脏病学 心脏病学
- 密集护理医学 密集护理医学
- 临床研究 临床研究
背景情况:
- 冲击学术研究联盟 (SHARC) 提出了务实的共识定义,以标准化心脏性冲击 (CS) 分类.
- 标准化定义对于在注册表和临床试验中持续收集数据至关重要.
研究的目的:
- 描述心脏重症监护室 (CICU) 人群中心脏性休克 (CS) 的当代流行病学.
- 评估Sharc定义在现实环境中的适用性.
主要方法:
- 利用来自关键护理心脏病学试验网络 (CCCTN) 的数据,这是一个先进的CICU的跨国研究网络.
- 应用了SHARC定义,根据病因 (AMI-CS,HF-CS,二次CS,混合CS) 和严重程度对CS进行分类.
- 分析了不同CS亚型的患者特征,治疗方式 (包括机械循环支持) 和住院死亡率.
主要成果:
- 在5869名CS患者中,27%患有急性心肌梗塞相关的CS (AMI-CS),59%患有心力衰竭相关的CS (HF-CS),14%患有二次性CS.
- HF-CS主要是急性至慢性 (72%). 混合CS占所有冲击病例的17%.
- AMI-CS和de novo HF-CS与更高的心脏骤停率有关. 艾米-CS和混合CS呈现出更严重的冲击阶段.
- 住院死亡率在混合CS (48%) 和AMI-CS (41%) 中最高,在急性与慢性HF-CS (25%) 中最低.
结论:
- 关于CS分类的SHARC共识定义在当代注册表中务实适用.
- 这些定义揭示了具有明显表型,治疗需求和结果的离散CS亚群.
- 这些发现对临床实践和心脏性休克管理的未来研究有影响.
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