Table 3.
Baseline Demographics, Hospital Characteristics, and Comorbidities of Patients With Cardiogenic Shock Complicating ST‐Elevation Myocardial Infarction
| Variable | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | P Value* |
|---|---|---|---|---|---|---|---|---|---|
| No. of cases (weighted) | 21 387 | 19 066 | 18 632 | 19 658 | 18 768 | 20 349 | 20 459 | 19 575 | — |
| Age, y | 69.3±12.7 | 70.0±12.7 | 69.4±13.0 | 68.2±12.7 | 68.7±13.0 | 68.0±13.1 | 67.2±12.8 | 67.7±12.9 | <0.001 |
| Sex | <0.001 | ||||||||
| Male | 57.9% | 58.8% | 58.6% | 62.5% | 60.6% | 62.2% | 63.3% | 63.5% | |
| Female | 42.1% | 41.2% | 41.4% | 37.5% | 39.4% | 37.8% | 36.7% | 36.5% | |
| Race | <0.001 | ||||||||
| White | 79.3% | 80.6% | 79.8% | 79.8% | 78.5% | 77.9% | 78.1% | 77.7% | |
| African American | 6.3% | 6.3% | 4.4% | 5.7% | 6.8% | 6.5% | 6.0% | 7.3% | |
| Hispanic | 7.6% | 6.5% | 8.7% | 7.5% | 7.9% | 6.9% | 6.9% | 7.2% | |
| Asian or Pacific Islander | 2.7% | 2.8% | 2.9% | 2.8% | 2.7% | 3.2% | 3.3% | 3.0% | |
| Other | 4.0% | 3.8% | 4.2% | 4.2% | 4.0% | 5.5% | 5.8% | 4.7% | |
| Primary expected payer | <0.001 | ||||||||
| Medicare | 62.5% | 61.5% | 60.9% | 57.2% | 56.1% | 55.9% | 53.2% | 55.0% | |
| Medicaid | 5.0% | 5.1% | 5.8% | 5.9% | 6.1% | 5.9% | 6.6% | 7.9% | |
| Private insurance | 26.3% | 25.4% | 25.2% | 28.3% | 27.9% | 27.9% | 30.1% | 27.0% | |
| Uninsured | 4.1% | 5.3% | 5.6% | 5.7% | 6.7% | 7.2% | 7.2% | 7.3% | |
| Other | 2.2% | 2.7% | 2.6% | 2.9% | 3.2% | 3.1% | 2.9% | 2.7% | |
| Median household income | 0.002 | ||||||||
| 0 to 25th Percentile | 26.3% | 26.7% | 25.8% | 23.1% | 26.5% | 27.1% | 25.7% | 28.0% | |
| 26th to 50th Percentile | 26.8% | 27.3% | 27.3% | 26.9% | 26.2% | 28.4% | 27.3% | 25.7% | |
| 51st to 75th Percentile | 25.6% | 22.9% | 23.9% | 26.6% | 24.4% | 24.0% | 25.2% | 24.2% | |
| 76th to 100th Percentile | 21.3% | 23.1% | 23.0% | 23.3% | 22.9% | 20.5% | 21.8% | 22.1% | |
| Weekend admission | 27.3% | 26.8% | 26.7% | 27.7% | 27.6% | 27.8% | 28.5% | 29.5% | <0.001 |
| Hospital characteristics | |||||||||
| Region | 0.329 | ||||||||
| Northeast | 17.8% | 16.3% | 17.5% | 15.8% | 18.5% | 17.6% | 17.0% | 19.0% | |
| Midwest | 23.8% | 23.4% | 24.3% | 25.4% | 24.2% | 24.4% | 22.7% | 26.2% | |
| South | 39.9% | 39.2% | 36.9% | 38.3% | 35.3% | 38.5% | 38.6% | 32.0% | |
| West | 18.5% | 21.1% | 21.3% | 20.5% | 22.0% | 19.4% | 21.7% | 22.8% | |
| Bed size | <0.001 | ||||||||
| Small | 6.9% | 7.9% | 4.2% | 9.7% | 7.6% | 7.8% | 6.0% | 8.8% | |
| Medium | 22.7% | 21.9% | 22.9% | 22.5% | 22.4% | 21.5% | 18.4% | 18.2% | |
| Large | 70.4% | 70.3% | 72.8% | 67.8% | 70.1% | 70.7% | 75.6% | 73.0% | |
| Urban location | 89.0% | 90.6% | 92.6% | 94.8% | 91.9% | 92.1% | 93.4% | 91.8% | <0.001 |
| Teaching hospital | 46.7% | 47.6% | 43.9% | 51.7% | 52.4% | 49.1% | 52.2% | 51.0% | <0.001 |
| Comorbidities | |||||||||
| Smoking | 14.1% | 14.6% | 17.4% | 18.2% | 20.5% | 24.4% | 32.3% | 30.6% | <0.001 |
| Dyslipidemia | 16.5% | 17.6% | 20.8% | 23.6% | 27.6% | 33.8% | 40.9% | 41.3% | <0.001 |
| CAD | 53.8% | 54.5% | 56.2% | 59.3% | 63.3% | 69.6% | 73.8% | 75.4% | <0.001 |
| Family history of CAD | 1.6% | 1.7% | 1.7% | 2.5% | 2.6% | 2.9% | 5.2% | 5.3% | <0.001 |
| Prior myocardial infarction | 4.0% | 4.4% | 4.2% | 4.2% | 5.5% | 5.3% | 6.6% | 7.6% | <0.001 |
| Carotid artery disease | 0.4% | 0.3% | 0.5% | 0.4% | 0.5% | 0.7% | 0.7% | 1.2% | <0.001 |
| Dementia | 2.7% | 3.4% | 3.7% | 3.4% | 3.7% | 3.7% | 4.2% | 4.8% | <0.001 |
| AIDS | 0.2% | 0.2% | 0.1% | 0.1% | 0.1% | 0.1% | 0.2% | 0.2% | 0.714 |
| Alcohol abuse | 2.2% | 2.2% | 2.5% | 3.3% | 3.4% | 3.2% | 3.4% | 3.7% | <0.001 |
| Deficiency anemias | 9.0% | 8.6% | 9.3% | 11.1% | 14.3% | 15.8% | 19.3% | 19.2% | <0.001 |
| RA/collagen vascular diseases | 1.4% | 1.4% | 1.3% | 1.5% | 1.8% | 2.0% | 1.4% | 1.7% | <0.001 |
| Chronic blood loss anemia | 1.2% | 1.4% | 1.9% | 1.8% | 2.2% | 1.1% | 1.5% | 1.1% | 0.017 |
| Congestive heart failure | 54.0% | 55.0% | 52.6% | 50.1% | 49.5% | 43.5% | 46.2% | 46.7% | <0.001 |
| Chronic pulmonary disease | 20.4% | 20.6% | 22.2% | 21.9% | 20.7% | 19.3% | 19.9% | 18.8% | <0.001 |
| Coagulopathy | 8.5% | 8.7% | 9.8% | 10.5% | 10.8% | 9.7% | 12.7% | 13.8% | <0.001 |
| Depression | 2.0% | 2.0% | 2.7% | 2.7% | 3.3% | 4.0% | 4.6% | 4.7% | <0.001 |
| Diabetes (uncomplicated) | 19.0% | 19.9% | 20.4% | 21.2% | 22.5% | 24.7% | 25.7% | 27.0% | <0.001 |
| Diabetes (complicated) | 3.7% | 3.6% | 3.6% | 4.0% | 3.9% | 3.9% | 4.2% | 4.3% | <0.001 |
| Drug abuse | 0.6% | 0.8% | 0.9% | 1.2% | 1.4% | 1.3% | 1.7% | 1.3% | <0.001 |
| Hypertension | 36.9% | 36.6% | 40.1% | 41.7% | 43.8% | 51.1% | 54.1% | 55.3% | <0.001 |
| Hypothyroidism | 4.3% | 4.7% | 5.4% | 5.3% | 6.1% | 6.3% | 6.9% | 7.2% | <0.001 |
| Liver disease | 0.9% | 0.9% | 0.6% | 0.8% | 1.3% | 0.9% | 1.4% | 1.3% | <0.001 |
| Lymphoma | 0.4% | 0.5% | 0.4% | 0.3% | 0.5% | 0.4% | 0.3% | 0.7% | 0.153 |
| Fluid and electrolyte disorder | 28.9% | 29.0% | 30.5% | 32.7% | 34.8% | 37.2% | 41.9% | 41.8% | <0.001 |
| Metastatic cancer | 0.7% | 0.7% | 0.8% | 0.8% | 1.0% | 0.6% | 0.9% | 1.1% | <0.001 |
| Other neurological disorders | 5.5% | 5.3% | 5.8% | 5.5% | 6.0% | 6.3% | 6.2% | 6.8% | <0.001 |
| Obesity | 4.3% | 3.8% | 4.5% | 4.8% | 5.8% | 8.7% | 9.8% | 10.1% | <0.001 |
| Paralysis | 1.4% | 1.3% | 1.4% | 1.3% | 1.3% | 2.2% | 1.5% | 2.2% | <0.001 |
| Peripheral vascular disease | 6.1% | 5.9% | 7.0% | 7.2% | 8.6% | 10.3% | 11.1% | 10.5% | <0.001 |
| Psychoses | 1.1% | 1.1% | 0.8% | 1.5% | 1.2% | 1.9% | 2.0% | 2.3% | <0.001 |
| Pulmonary circulation disorders | 0.2% | 0.1% | 0.1% | 0.1% | 0.1% | 0.1% | 0.3% | 0.3% | <0.001 |
| Renal failure (chronic) | 8.9% | 9.0% | 10.6% | 15.2% | 15.5% | 14.7% | 15.8% | 16.4% | <0.001 |
| Solid tumor without metastasis | 1.3% | 1.5% | 1.4% | 1.3% | 1.5% | 1.6% | 1.3% | 1.7% | 0.008 |
| Peptic ulcer (nonbleeding) | <0.01% | <0.01% | <0.01% | 0.0% | 0.0% | <0.01% | <0.01% | <0.01% | 0.946 |
| Valvular disease | 0.9% | 0.8% | 0.8% | 1.0% | 1.0% | 0.6% | 0.6% | 0.6% | <0.001 |
| Weight loss | 2.0% | 2.5% | 3.0% | 4.0% | 3.3% | 4.8% | 6.3% | 6.1% | <0.001 |
| Presentation | 0.003 | ||||||||
| Anterior wall STEMI | 41.1% | 41.4% | 42.1% | 42.3% | 42.4% | 43.8% | 42.8% | 42.6% | |
| Inferior wall STEMI | 38.6% | 38.4% | 38.3% | 39.3% | 39.3% | 37.7% | 39.0% | 38.2% | |
| Other STEMI | 20.4% | 20.2% | 19.6% | 18.3% | 18.3% | 18.5% | 18.2% | 19.2% |
Data are expressed as mean±standard deviation for continuous variables and number (percentage) for categorical variables. AIDS indicates acquired immunodeficiency syndrome; CAD, coronary artery disease; RA, rheumatoid arthritis; STEMI, ST‐elevation myocardial infarction.
*
P value for trend.