Survival of patients treated with intra-aortic balloon counterpulsation for cardiogenic shock in a tertiary centre: variables correlated with death.
OBJECTIVE
To describe the characteristics and mortality rates of 132 cardiogenic shock patients treated with intra-aortic balloon counterpulsation at a university hospital.


METHODS
All patients underwent intra-aortic balloon counterpulsation. A total of 99 out of 132 patients were revascularized with angioplasty, surgery or were transplanted (intervention group), 33 out of 132 had no further intervention (no-intervention group).


RESULTS
Overall mortality was 54.5% (72/132). In the intervention group mortality was 50.5% (50/99), in the no-intervention group mortality was 66.6% (22/33). The odds ratio for death comparing the intervention group with the no-intervention group was 0.533 (95% confidence interval 0.238-1.189, P = 0.122). By univariate analysis, diabetes and a left ventricular ejection fraction of less than 0.35 represented an increased odds ratio of death of 4.25 (1.813-9.965, P = 0.001) and 3.03 (1.22-7.54, P = 0.015), respectively. A lactate level greater than 2.5 mg/dl at baseline resulted in an increased odds ratio of death of 5.185 (1.988-13.525, P = 0.0001). Using a multivariate logistic regression analysis, a left ventricular ejection fraction less than 0.35 and diabetes remained significantly correlated with death.


CONCLUSIONS
Mortality rates remain high in cardiogenic shock patients in need of intra-aortic balloon counterpulsation. The odds ratio for death tended to be lower in the intervention group compared with the no-intervention group, although the absolute difference in mortality as a result of an intervention was only 15.2%, and did not reach statistical significance probably because of the small sample size. Diabetes and an ejection fraction lower than 35% are significant predictors for a worse prognosis.
Dens
Joseph
J
Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B 3000 Leuven, Belgium. Joseph.Dens@uz.kuleuven.ac.be
Dubois
Christophe
C
Ector
Hugo
H
Desmet
Walter
W
Janssens
Stefan
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000145:classification / Q000706:statistics & numerical data; D015897:Comorbidity; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006439:Hemodynamics; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000401:mortality* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000145:classification / Q000453:epidemiology; D009204:Myocardial Revascularization; D016017:Odds Ratio; D012189:Retrospective Studies; D017678:Sex Distribution; D012770:Shock, Cardiogenic / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis