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Observational Study
. 2022 Feb;9(1):408-419.
doi: 10.1002/ehf2.13734. Epub 2021 Dec 31.

Baseline characteristics, management, and predictors of early mortality in cardiogenic shock: insights from the FRENSHOCK registry

Clement Delmas  1 , François Roubille  2 , Nicolas Lamblin  3 , Laurent Bonello  4 , Guillaume Leurent  5 , Bruno Levy  6 , Meyer Elbaz  1 , Nicolas Danchin  7 , Sebastien Champion  8 , Pascal Lim  9 , Francis Schneider  10 , Alain Cariou  11 , Hadi Khachab  12 , Jeremy Bourenne  13 , Marie-France Seronde  14 , Guillaume Schurtz  3 , Brahim Harbaoui  15 , Gerald Vanzetto  16 , Charlotte Quentin  17 , Xavier Delabranche  18 , Nadia Aissaoui  19 , Nicolas Combaret  20 , Stephane Manzo-Silberman  21 , Danka Tomasevic  22 , Benjamin Marchandot  23 , Benoit Lattuca  24 , Patrick Henry  21 , Edouard Gerbaud  25 , Eric Bonnefoy  22 , Etienne Puymirat  7
Affiliations
Observational Study

Baseline characteristics, management, and predictors of early mortality in cardiogenic shock: insights from the FRENSHOCK registry

Clement Delmas et al. ESC Heart Fail. 2022 Feb.

Abstract

Aims: Published data on cardiogenic shock (CS) are scarce and are mostly focused on small registries of selected populations. The aim of this study was to examine the current CS picture and define the independent correlates of 30 day mortality in a large non-selected cohort.

Methods and results: FRENSHOCK is a prospective multicentre observational survey conducted in metropolitan French intensive care units and intensive cardiac care units between April and October 2016. There were 772 patients enrolled (mean age 65.7 ± 14.9 years; 71.5% male). Of these patients, 280 (36.3%) had ischaemic CS. Organ replacement therapies (respiratory support, circulatory support or renal replacement therapy) were used in 58.3% of patients. Mortality at 30 days was 26.0% in the overall population (16.7% to 48.0% depending on the main cause and first place of admission). Multivariate analysis showed that six independent factors were associated with a higher 30 day mortality: age [per year, odds ratio (OR) 1.06, 95% confidence interval (CI): 1.04-1.08], diuretics (OR 1.74, 95% CI: 1.05-2.88), circulatory support (OR 1.92, 95% CI: 1.12-3.29), left ventricular ejection fraction <30% (OR 2.15, 95% CI: 1.40-3.29), norepinephrine (OR 2.55, 95% CI: 1.69-3.84), and renal replacement therapy (OR 2.72, 95% CI: 1.65-4-49).

Conclusions: Non-ischaemic CS accounted for more than 60% of all cases of CS. CS is still associated with significant but variable short-term mortality according to the cause and first place of admission, despite frequent use of haemodynamic support, and organ replacement therapies.

Keywords: Cardiogenic shock; Epidemiology; Mortality; Organ support.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Cardiogenic shock trigger (in blue) and associated 30 day mortality (in red). For all patients who meet the FRENSHOCK criteria (n = 772), the cardiogenic shock trigger and the associated 30 day mortality are summarized. Up to three CS triggers (not mutually exclusive) were identified by the local investigator for each patient (i.e. ischaemic, ventricular, and supraventricular arrhythmia, conduction disorder, infectious disease, non‐compliance or iatrogenesis).
Figure 2
Figure 2
Central illustration: the FRENSHOCK registry—a real‐life picture of cardiogenic shock in France. CS, cardiogenic shock; LVEF, left ventricular ejection fraction; MCS, mechanical circulatory support; RRT, renal replacement therapy.
See this image and copyright information in PMC

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