Lim Hoong Sern, Mascaro Jorge
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK.
JHLT Open. 2024 Mar 2;4:100077. doi: 10.1016/j.jhlto.2024.100077. eCollection 2024 May.
End-stage heart failure-related cardiogenic shock (HF-CS) is associated with high risk of short-term mortality, but the causes and mode of death in HF-CS have not been described. This study aimed to (i) describe the causes/modes of death in patients with HF-CS based on the phases-of-care (Rescue-Optimization-Stabilization-Exit therapy), analogous to the phase-of-care mortality analysis, and (ii) assess the impact of the introduction of a standardized team-based care. We included 120 consecutive patients with HF-CS who underwent temporary mechanical circulatory support. The introduction of standardized team-based care reduced mortality at 6 months (36/63 (57%) vs 17/57 (30%), = 0.003), but did not alter the distribution of phase-of-care mortality. There were fewer deaths following heart transplantation/left ventricular assist device therapy with standardized team-based care (6% vs 28%, = 0.067) may be clinically relevant.
终末期心力衰竭相关的心源性休克（HF-CS）与短期死亡的高风险相关，但HF-CS的死因和死亡方式尚未得到描述。本研究旨在：（i）基于照护阶段（抢救-优化-稳定-出院治疗）描述HF-CS患者的死因/死亡方式，类似于照护阶段死亡率分析；（ii）评估引入标准化团队照护的影响。我们纳入了120例接受临时机械循环支持的连续性HF-CS患者。引入标准化团队照护降低了6个月时的死亡率（63例中的36例（57%）对比57例中的17例（30%），P = 0.003），但并未改变照护阶段死亡率的分布。在接受心脏移植/左心室辅助装置治疗时，标准化团队照护下的死亡人数较少（6%对比28%，P = 0.067），这可能具有临床意义。
