Pasienter innlagt med kardiogent sjokk - en retrospektiv studie

Abstract

Background: There are no studies to date on the clinical course of patients with cardiogenic shock in Norway. The purpose of this study was to examine the clinical course of patients with cardiogenic shock at a Norwegian university hospital.

Material and method: We conducted a retrospective analysis of patients admitted to the Department of Cardiology, Haukeland University Hospital with cardiogenic shock during the period 1 October 2020 to 30 September 2022.

Results: Of the 64 patients in the study, 43 were men, and the median age was 69 years (interquartile range 58-77 years). On admission to the intensive care unit (ICU), the median arterial blood lactate level was 4.0 (2.3-8.6) mmol/L, pH was 7.28 (7.21-7.40) and the serum troponin-T level was 539 (97-2733) ng/L. Acute myocardial infarction was the primary cause in 32 of the 64 patients, and 37 had at least one complicating acute and/or chronic heart condition. A total of 32 of the 64 patients received mechanical circulatory support. The most frequent extracardiac organ failures while in the ICU were acute respiratory failure (54 out of 64 patients, of whom 37 received mechanical ventilation), acute kidney injury (52 out of 64 patients, of whom 11 received renal replacement therapy) and delirium (20 out of 64 patients). Twenty-three of the 64 patients died in the ICU, and 31 of the remaining 63 died within one year.

Interpretation: Cardiogenic shock was characterised by heterogeneous primary aetiologies in our population. Many patients presented with concomitant acute and/or chronic heart disease and acute extracardiac organ failure, which required advanced organ support. One-year mortality among patients with cardiogenic shock was high.