■心源性休克(CS)是一种危及生命的疾病。这项研究的目的是评估临床特征,管理,意大利一家高容量医院收治的CS患者的并发症发生率。我们回顾性回顾了临床,超声心动图,和实验室数据,治疗管理,2020年1月1日至2023年1月1日期间入住PoliclinicoGemelli(罗马)的CS患者的结局。我们纳入了96名患者[中位年龄71岁,四分位数间距60-79;65(68%)男性],其中49例(51%)出现继发于急性心肌梗死的CS,60例(63%)出现从头出现CS。多巴酚丁胺是最常用的强化剂,去甲肾上腺素是最常用的血管加压药(56%和82%的病例采用,分别)。45名(47%)患者在住院期间死亡。非幸存者年龄较大,入院时炎症负担较高,乳酸水平升高,乳酸水平的增加更大,左心室充盈压较高,右心室功能更差.C反应蛋白水平[比值比(OR)1.03,95%置信区间(CI)(1.00-1.04),P=0.027],入院时的乳酸水平(OR3.49,95%CI,1.59-7.63,P=0.02),乳酸水平升高(OR2.8,95%CI,1.37-5.75,P=0.005)是住院全因死亡的独立预测因子。我们的数据有助于评估CS患者的管理和结果的区域差异。我们观察到高死亡率和并发症发生率。入院时测量乳酸酸中毒和C反应蛋白可能有助于识别住院不良结局风险较高的患者。
UNASSIGNED: Cardiogenic shock (CS) is a life-threatening condition. The aim of this study is to evaluate the clinical characteristics, management, and complication rate of patients with CS admitted to a high-volume hospital in Italy. We retrospectively reviewed the clinical, echocardiographic, and laboratory data, therapeutic management, and outcomes of patients with CS admitted to the Policlinico Gemelli (Rome) between January 1, 2020, and January 1, 2023. We included 96 patients [median age 71 years, interquartile range 60-79; 65 (68%) males], of whom 49 patients (51%) presented CS secondary to acute myocardial infarction and 60 (63%) with a de novo presentation of CS. Dobutamine was the most frequently used inotrope and noradrenaline the most frequently used vasopressor (adopted in 56% and 82% of cases, respectively). Forty-five (47%) patients died during the hospitalization. Nonsurvivors were older and had a higher inflammatory burden at admission, elevated lactate levels, a greater increase in lactate levels, higher left ventricular filling pressures, and worse right ventricular function. C-reactive protein levels [odds ratio (OR) 1.03, 95% confidence interval (CI) (1.00-1.04), P = 0.027], lactate levels at admission (OR 3.49, 95% CI, 1.59-7.63, P = 0.02), and increase in lactate levels (OR 2.8, 95% CI, 1.37-5.75, P = 0.005) were independent predictors of in-hospital all-cause death. Our data contribute to the assessment of the regional variations in the management and outcomes of patients with CS. We observed a high mortality and complication rate. Lactate acidosis and C-reactive protein measured at admission may help in identifying patients at higher risk of adverse in-hospital outcomes.