Table 1.
Comparison of Patients With and Without Shock During the First 24 h, Including Those With Admission (Prevalent) Shock Versus Late (Incident) Shock
| Total (N=2918) | No shock (N=1381) | Any shock (N=1537) | Late shock (N=633) | Admission shock (N=904) | P value (any shock vs no shock) | P value (late shock vs admission shock) | P value (late shock vs no shock) | |
|---|---|---|---|---|---|---|---|---|
| Demographics | ||||||||
| Age, y | 70.0 (60.0–80.0) | 69.0 (58.0–79.0) | 71.0 (61.0–81.0) | 72.0 (60.0–82.0) | 71.0 (61.0–80.0) | <0.001 | 0.733 | <0.001 |
| Female sex | 1150 (39.4) | 511 (37.0) | 639 (41.6) | 275 (43.4) | 364 (40.3) | 0.012 | 0.213 | 0.006 |
| White race | 2707 (92.8) | 1284 (93.0) | 1423 (92.6%) | 585 (92.4) | 838 (92.7) | 0.682 | 0.835 | 0.652 |
| CCI | 2.0 (0.0–4.0) | 1.0 (0.0–3.0) | 2.0 (0.0–4.0) | 2.0 (0.0, 4.0) | 2.0 (0.0–4.0) | <0.001 | 0.986 | <0.001 |
| Admit source | 0.004 | 0.299 | 0.146 | |||||
| Catheterization laboratory | 1107 (38.5) | 525 (39.1) | 582 (37.9) | 239 (37.8) | 343 (38.0) | |||
| Direct admit | 763 (26.5) | 361 (26.9) | 402 (26.2) | 158 (25.0) | 244 (27.1) | |||
| ED | 481 (16.7) | 233 (17.3) | 248 (16.2) | 106 (16.8) | 142 (15.7) | |||
| Floor | 432 (15.0) | 200 (14.9) | 232 (15.1) | 105 (16.6) | 127 (14.1) | |||
| ICU | 42 (1.5) | 13 (1.0) | 29 (1.9) | 13 (2.1) | 16 (1.8) | |||
| OR/PACU | 53 (1.8) | 12 (0.9) | 41 (2.7) | 11 (1.7) | 30 (3.3) | |||
| Admission diagnoses and comorbidities | ||||||||
| Cardiac arrest | 338 (11.6) | 92 (6.7) | 246 (16.0) | 55 (8.7) | 191 (21.2) | <0.001 | <0.001 | <0.001 |
| Any shock | 566 (19.5) | 114 (8.3) | 452 (29.5) | 95 (15.1) | 357 (39.6) | <0.001 | <0.001 | 0.105 |
| CS | 450 (15.5) | 93 (6.8) | 357 (23.3) | 70 (11.1) | 287 (31.8) | <0.001 | <0.001 | <0.001 |
| Sepsis | 202 (6.9) | 40 (2.9) | 162 (10.6) | 41 (6.5) | 121 (13.4) | <0.001 | <0.001 | <0.001 |
| Respiratory failure | 977 (33.6) | 344 (25.0) | 633 (41.3) | 210 (33.3) | 423 (46.9) | <0.001 | <0.001 | <0.001 |
| ACS | 1209 (41.6) | 588 (42.7) | 621 (40.5) | 252 (39.9) | 369 (40.9) | 0.224 | 0.703 | 0.238 |
| HF | 1681 (57.8) | 709 (51.5) | 972 (63.4) | 382 (60.5) | 590 (65.4) | <0.001 | 0.051 | <0.001 |
| CKD | 652 (22.5) | 275 (20.1) | 377 (24.7) | 147 (23.3) | 230 (25.7) | 0.003 | 0.290 | 0.106 |
| Prior dialysis | 89 (3.0) | 25 (1.8) | 64 (4.2) | 25 (3.9) | 39 (4.3) | <0.001 | 0.725 | 0.004 |
| Severity of illness | ||||||||
| SOFA Score | 2.0 (1.0–5.0) | 2.0 (1.0–3.0) | 4.0 (2.0–7.0) | 3.0 (1.0–5.0) | 5.0 (2.0–8.0) | <0.001 | <0.001 | <0.001 |
| APACHE III score | 56.0 (43.0–70.0) | 50.0 (37.0–61.0) | 63.0 (49.0–79.0) | 58.0 (45.0–71.0) | 67.0 (53.0–85.0) | <0.001 | <0.001 | <0.001 |
| APACHE IV predicted mortality rate, % | 9.4 (4.2–20.6) | 6.5 (3.0–13.4) | 13.0 (5.8–29.1) | 10.4 (4.6–21.0) | 15.8 (6.8–38.4) | <0.001 | <0.001 | <0.001 |
| LVEF, % | 51.0 (36.0–60.0) | 53.0 (40.0–61.0) | 50.0 (33.0–60.0) | 52.0 (37.0–61.0) | 48.0 (30.0–60.0) | <0.001 | 0.002 | 0.533 |
| Maximum SCAI shock stage | <0.001 | <0.001 | <0.001 | |||||
| A | 548 (18.8) | 548 (39.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| B | 833 (28.5) | 833 (60.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| C | 1269 (43.5) | 0 (0.0) | 1269 (82.6) | 603 (95.3) | 666 (73.7) | |||
| D | 115 (3.9) | 0 (0.0) | 115 (7.5) | 17 (2.7) | 98 (10.8) | |||
| E | 153 (5.2) | 0 (0.0) | 153 (10.0) | 13 (2.1) | 140 (15.5) | |||
| Critical care therapies and procedures | ||||||||
| IMV | 470 (16.1) | 85 (6.2) | 385 (25.0) | 90 (14.2) | 295 (32.6) | <0.001 | <0.001 | <0.001 |
| NIPPV | 483 (16.6) | 203 (14.7) | 280 (18.2) | 116 (18.3) | 164 (18.1) | 0.011 | 0.927 | 0.039 |
| CRRT | 47 (1.6) | 7 (0.5) | 40 (2.6) | 12 (1.9) | 28 (3.1) | <0.001 | 0.145 | 0.003 |
| Dialysis | 96 (3.3) | 21 (1.5) | 75 (4.9) | 27 (4.3) | 48 (5.3) | <0.001 | 0.350 | <0.001 |
| Vasopressors | 638 (21.9) | 66 (4.8) | 572 (37.2) | 105 (16.6) | 467 (51.7) | <0.001 | <0.001 | <0.001 |
| Inotropes | 231 (7.9) | 77 (5.6) | 154 (10.0) | 48 (7.6) | 106 (11.7) | <0.001 | 0.008 | 0.083 |
| Vasoactives | 745 (25.5) | 131 (9.5) | 614 (39.9) | 128 (20.2) | 486 (53.8) | <0.001 | <0.001 | <0.001 |
| IABP | 197 (6.8) | 28 (2.0) | 169 (11.0) | 27 (4.3) | 142 (15.7) | <0.001 | <0.001 | 0.004 |
| Impella/ECMO | 56 (1.9) | 16 (1.2) | 40 (2.6) | 12 (1.9) | 28 (3.1) | 0.005 | 0.145 | 0.257 |
| PAC | 451 (15.5) | 167 (12.1) | 284 (18.5) | 88 (13.9) | 196 (21.7) | <0.001 | <0.001 | 0.190 |
| Catheterization | 1565 (53.6) | 750 (54.3) | 815 (53.0) | 334 (52.8) | 481 (53.2) | 0.488 | 0.864 | 0.519 |
| PCI | 818 (28.0) | 428 (31.0) | 390 (25.4) | 170 (26.9) | 220 (24.3) | <0.001 | 0.264 | 0.059 |
| Transfusion | 212 (7.3) | 45 (3.3) | 167 (10.9) | 63 (10.0) | 104 (11.5) | <0.001 | 0.336 | <0.001 |
| Outcomes | ||||||||
| CICU LOS, d | 1.6 (0.9–2.5) | 1.2 (0.8–2.0) | 1.8 (1.0–2.9) | 1.8 (1.1–2.8) | 1.8 (1.0–3.0) | <0.001 | 0.617 | <0.001 |
| CICU LOS <1 d | 881 (30.2) | 519 (37.6) | 362 (23.6) | 133 (21.0) | 229 (25.3) | <0.001 | 0.049 | <0.001 |
| Hospital LOS, d | 4.7 (2.6–8.1) | 3.8 (2.2–7.0) | 5.4 (3.0–9.3) | 5.0 (2.9–9.0) | 5.8 (3.0–9.3) | <0.001 | 0.333 | <0.001 |
| CICU mortality | 157 (5.4) | 20 (1.4) | 137 (8.9) | 27 (4.3) | 110 (12.2) | <0.001 | <0.001 | <0.001 |
| Early death | 73 (2.5) | 15 (1.1) | 58 (3.8) | 5 (0.8) | 53 (5.9) | <0.001 | <0.001 | <0.001 |
| In‐hospital mortality | 266 (9.1) | 48 (3.5) | 218 (14.2) | 57 (9.0) | 161 (17.8) | <0.001 | <0.001 | <0.001 |
Categorical variables were reported as numbers (percentages), and continuous variables were reported as medians (interquartile ranges). ACS indicates acute coronary syndrome; APACHE, Acute Physiology and Chronic Health Evaluation; CCI, Charlson Comorbidity Index; CICU, cardiac intensive care unit; CKD, chronic kidney disease; CRRT, continuous renal replacement therapy; CS, cardiogenic shock; ECMO, extracorporeal membrane oxygenation; ED, emergency department; HF, heart failure; IABP, intra‐aortic balloon pump; ICU, intensive care unit; IMV, invasive mechanical ventilation; LOS, length of stay; LVEF, left ventricular ejection fraction; NIPPV, noninvasive positive pressure ventilation; OR, operating room; PAC, pulmonary artery catheter; PACU, postanesthesia care unit; PCI, percutaneous coronary intervention; SCAI, Society for Cardiovascular Angiography and Interventions; and SOFA, Sequential Organ Failure Assessment.