Dataset Information

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock.

ABSTRACT:

Objective

To evaluate the prevalence and impact of respiratory infections in cardiogenic shock complicating acute myocardial infarction (AMI-CS).

Methods

Using the National Inpatient Sample (2000-2017), this study identified adult (≥18 years) admitted with AMI-CS complicated by respiratory infections. Outcomes of interest included in-hospital mortality of AMI-CS admissions with and without respiratory infections, hospitalization costs, hospital length of stay, and discharge disposition. Temporal trends of prevalence, in-hospital mortality and cardiac procedures were evaluated.

Results

Among 557,974 AMI-CS admissions, concomitant respiratory infections were identified in 84,684 (15.2%). Temporal trends revealed a relatively stable trend in prevalence of respiratory infections over the 18-year period. Admissions with respiratory infections were on average older, less likely to be female, with greater comorbidity, had significantly higher rates of NSTEMI presentation, and acute non-cardiac organ failure compared to those without respiratory infections (all p < 0.001). These admissions received lower rates of coronary angiography (66.8% vs 69.4%, p < 0.001) and percutaneous coronary interventions (44.8% vs 49.5%, p < 0.001), with higher rates of mechanical circulatory support, pulmonary artery catheterization, and invasive mechanical ventilation compared to AMI-CS admissions without respiratory infections (all p < 0.001). The in-hospital mortality was lower among AMI-CS admissions with respiratory infections (31.6% vs 38.4%, adjusted OR 0.58 [95% CI 0.57-0.59], p < 0.001). Admissions with respiratory infections had longer lengths of hospital stay (12^7-20 vs 6^3-11 days, p < 0.001), higher hospitalization costs and less frequent discharges to home (27.1% vs 44.7%, p < 0.001).

Conclusions

Respiratory infections in AMI-CS admissions were associated with higher resource utilization but lower in-hospital mortality.

SUBMITTER: Patlolla SH

PROVIDER: S-EPMC8514410 | biostudies-literature | 2021 Sep-Oct

REPOSITORIES: biostudies-literature

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Publications

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock.

Patlolla Sri Harsha SH Sundaragiri Pranathi R PR Cheungpasitporn Wisit W Doshi Rajkumar R Vallabhajosyula Saraschandra S

Indian heart journal 20210717 5

<h4>Objective</h4>To evaluate the prevalence and impact of respiratory infections in cardiogenic shock complicating acute myocardial infarction (AMI-CS).<h4>Methods</h4>Using the National Inpatient Sample (2000-2017), this study identified adult (≥18 years) admitted with AMI-CS complicated by respiratory infections. Outcomes of interest included in-hospital mortality of AMI-CS admissions with and without respiratory infections, hospitalization costs, hospital length of stay, and discharge dispos ...[more]

PMID: 34627570

Similar Datasets

Project description:ObjectivesMixed cardiogenic-septic shock is common and associated with high mortality. There are limited contemporary data on concomitant sepsis in acute myocardial infarction complicated by cardiogenic shock (AMI-CS).DesignObservational study.SettingTwenty percent stratified sample of all community hospitals (2000-2014) in the United States.ParticipantsAdults (> 18 yr) with AMI-CS with and without concomitant sepsis.InterventionsNone.Measurements and main resultsOutcomes of interest included inhospital mortality, development of noncardiac organ failure, complications, utilization of guideline-directed procedures, length of stay, and hospitalization costs. Over 15 years, 444,253 AMI-CS admissions were identified, of which 27,057 (6%) included sepsis. The sepsis cohort had more comorbidities and had higher rates of noncardiac multiple organ failure (92% vs 69%) (all p < 0.001). In 2014, compared with 2000, the prevalence of sepsis increased from 0.5% versus 11.5% with an adjusted odds ratio (aOR) 11.71 (95% CI, 9.7-14.0) in ST-segment elevation myocardial infarction and 24.6 (CI, 16.4-36.7) (all p < 0.001) in non-ST segment elevation myocardial infarction. The sepsis cohort received fewer cardiac interventions (coronary angiography [65% vs 68%], percutaneous coronary intervention [43% vs 48%]) and had greater use of mechanical circulatory support (48% vs 45%) and noncardiac support (invasive mechanical ventilation [65% vs 41%] and acute hemodialysis [12% vs 3%]) (p < 0.001). The sepsis cohort had higher inhospital mortality (44.3% vs 38.1%; aOR, 1.21; 95% CI, 1.18-1.25; p < 0.001), longer length of stay (14.0 d [7-24 d] vs 7.0 d [3-12 d]), greater hospitalization costs (×1,000 U.S. dollars) ($176.0 [$85-$331] vs $77.0 [$36-$147]), fewer discharges to home (22% vs 44%) and more discharges to skilled nursing facilities (51% vs 28%) (all p < 0.001).ConclusionsIn AMI-CS, concomitant sepsis is associated with higher mortality and morbidity highlighting the need for early recognition and integrated management of mixed shock.

Dataset Information

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock.

Objective

Methods

Results

Conclusions

Publications

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock.

Similar Datasets

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