Table 4.
In-hospital management and prognosis of cardiogenic shock patients according to the presence of mottling at admission
| Overall (n = 660) | No mottling (n = 404) | Mottling (n = 256) | p | ||||
|---|---|---|---|---|---|---|---|
| Medications used, n (%) | |||||||
| Diuretics | 532/657 | 81.0 | 332/402 | 82.6 | 200/255 | 78.4 | 0.186 |
| Volume expander | 281/656 | 42.8 | 153/401 | 38.2 | 128/255 | 50.2 | 0.002 |
| Dobutamine | 540/657 | 82.2 | 329/402 | 81.8 | 211/255 | 82.8 | 0.768 |
| If yes, maximum dose (mg/kg/min) | 0.007 | ||||||
| 5–10 | 340 | 62.6 | 225 | 68.0 | 115 | 54.2 | |
| 10–15 | 121 | 22.3 | 59 | 17.8 | 62 | 29.2 | |
| > 15 | 44 | 8.1 | 26 | 7.9 | 18 | 8.5 | |
| Unknown | 38 | 7.0 | 21 | 6.3 | 17 | 8.0 | |
| Norepinephrine | 344/657 | 52.4 | 194/402 | 48.3 | 150/255 | 58.8 | 0.008 |
| If yes, maximum dose (mg/h) | 0.128 | ||||||
| < 1 | 67 | 19.3 | 44 | 22.4 | 23 | 15.2 | |
| 1–5 | 177 | 51.0 | 99 | 50.5 | 78 | 51.7 | |
| > 5 | 71 | 20.5 | 33 | 16.8 | 38 | 25.2 | |
| Unknown | 32 | 9.2 | 20 | 10.2 | 12 | 7.9 | |
| Epinephrine | 86/657 | 13.1 | 39/402 | 9.7 | 47/255 | 18.4 | 0.001 |
| If yes, maximum dose (mg/h) | 0.395 | ||||||
| < 1 | 32 | 36.0 | 18 | 43.9 | 14 | 29.2 | |
| 1–5 | 34 | 38.2 | 12 | 29.3 | 22 | 45.8 | |
| > 5 | 13 | 14.6 | 6 | 14.6 | 7 | 14.6 | |
| Unknown | 10 | 11.2 | 5 | 12.2 | 5 | 10.4 | |
| Norepinephrine + dobutamine combination | 299/657 | 45.5 | 165/402 | 41.0 | 134/255 | 52.6 | 0.004 |
| Levosimendan | 47/657 | 7.2 | 34/402 | 8.5 | 13/255 | 5.1 | 0.576 |
| Dopamine | 1/657 | 0.2 | 0/402 | 0.0 | 1/255 | 0.4 | 1.000 |
| Isoprenaline | 30/657 | 4.6 | 15/402 | 3.7 | 15/255 | 5.9 | 0.198 |
| Antiarrhythmic | 261/657 | 39.7 | 154/402 | 38.3 | 107/255 | 42.0 | 0.351 |
| Transfusion | 115/656 | 17.5 | 60/401 | 15.0 | 55/255 | 21.6 | 0.030 |
| Fibrinolysis | 11/656 | 1.7 | 5/401 | 1.3 | 6/255 | 2.4 | 0.353 |
| Organ replacement therapies, n (%) | |||||||
| Respiratory support | |||||||
| Invasive | 249/657 | 37.9 | 121/402 | 30.1 | 128/255 | 50.2 | < 0.001 |
| Non-invasive | 183/657 | 27.9 | 103/402 | 25.6 | 80/255 | 31.4 | 0.109 |
| Mechanical circulatory support | 122/658 | 18.5 | 66/402 | 16.4 | 56/256 | 21.9 | 0.079 |
| If yes | |||||||
| IABP | 43/121 | 35.5 | 23/66 | 34.9 | 20/55 | 36.4 | 0.862 |
| Impella | 22/121 | 18.2 | 11/66 | 16.7 | 11/55 | 20.0 | 0.636 |
| ECLS | 72/121 | 59.5 | 37/66 | 56.1 | 35/55 | 63.6 | 0.398 |
| Renal replacement therapy | 101/659 | 15.3 | 50/403 | 12.4 | 51/256 | 19.9 | 0.009 |
| Invasive cardiology, n (%) | |||||||
| CAG | 346 | 52.4 | 219 | 54.2 | 127 | 49.6 | 0.249 |
| If yes | |||||||
| CAG result | 0.205 | ||||||
| Normal | 61 | 17.6 | 39 | 17.8 | 22 | 17.3 | |
| 1—Mono | 71 | 20.5 | 51 | 23.3 | 20 | 15.7 | |
| 2—Bi | 80 | 23.1 | 49 | 22.4 | 31 | 24.4 | |
| 3—Tri | 76 | 22.0 | 50 | 22.8 | 26 | 20.5 | |
| Unknown | 58 | 16.8 | 30 | 13.7 | 28 | 22.0 | |
| Culprit lesion | 225/281 | 80.1 | 143/178 | 80.3 | 82/103 | 79.6 | 0.883 |
| Any PCI | 192 | 29.1 | 121 | 30.0 | 71 | 27.7 | 0.541 |
| Right heart catheterisation | 107/657 | 16.3 | 70/402 | 17.4 | 37/255 | 14.5 | 0.326 |
| Pace-maker implantation | 28/625 | 4.5 | 16/388 | 4.1 | 12/237 | 5.1 | 0.582 |
| Defibrillator implantation | 31/625 | 5.0 | 18/388 | 4.6 | 13/237 | 5.5 | 0.636 |
| Radiofrequency ablation | 15/625 | 2.4 | 13/388 | 3.4 | 2/237 | 0.8 | 0.047 |
| Discharge | |||||||
| LVEF (%), mean ± SD | 34.8 | ± 14.2 | 34.2 | ± 13.7 | 36 | ± 14.9 | 0.221 |
| n | 375 | 240 | 135 | ||||
| LVEF variation*, mean ± SD | 8.2 | ± 14.0 | 7.4 | ± 13.7 | 9.5 | ± 14.5 | 0.172 |
| n | 372 | 238 | 134 | ||||
| Length of stay in ICU/ICCU (days), median (IQR) | 12 (7–21) | 11 (7–20) | 13 (8–25) | 0.061 | |||
| n | 380 | 232 | 148 | ||||
| Length of stay in hospital (days), median (IQR) | 16 (11–27) | 16 (11–25) | 19 (12–31) | 0.033 | |||
| n | 367 | 238 | 129 | ||||
| Discharge mode | 0.074 | ||||||
| Home | 141 | 25.4 | 96 | 28.3 | 45 | 20.8 | |
| Rehabilitation | 38 | 6.8 | 23 | 6.8 | 15 | 6.9 | |
| Transferred (other center/other department) | 183 | 33.0 | 116 | 34.2 | 67 | 31.0 | |
| Death | 190 | 34.2 | 103 | 30.4 | 87 | 40.3 | |
| Other | 3 | 0.5 | 1 | 0.3 | 2 | 0.9 | |
| Registration on transplant waiting list | 33/552 | 6.0 | 21/333 | 6.3 | 12/219 | 5.5 | 0.689 |
| Mortality | |||||||
| 30-day mortality | 173 | 26.2 | 94 | 23.3 | 79 | 30.9 | 0.031 |
| 1-year mortality** | 308 | 46.7 | 170 | 42.1 | 138 | 53.9 | 0.003 |
Values in italics indicate the number of patients included in the statistical analysis
CAG, coronary arteriography; ECLS, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; ICCU, intensive cardiac care unit; ICU, intensive care unit; IQR, interquartile range; LVEF, left ventricular ejection fraction; PCI, percutaneous coronary intervention; SD, standard deviation
*At discharge compared with admission
**2.5% of patients lost to follow-up at 1-year