Journal of Interventional Cardiology

Research Article

Comparison of Mortality Risk Models in Patients with Postcardiac Arrest Cardiogenic Shock and Percutaneous Mechanical Circulatory Support

Table 1

Demographics and baseline characteristics of the study population.


	Impella 2.5 (N = 65)	Survivors (N = 29)	Nonsurvivors (N = 36)	value	Impella CP (N = 32)	Survivors (N = 14)	Nonsurvivors (N = 18)	value

Age, years	67.86 ± 12.82	59.90 ± 12.23	74.28 ± 9.29	<0.001	66 ± 13.92	55.43 ± 13.30	74.22 ± 7.39	<0.001
Gender, male/female	55/10	25/4	30/6	1	20/12	10/4	10/8	0.47
BMI, kg/m²	27.60 ± 3.63	26.63 ± 2.91	28.35 ± 3.98	0.06	29.01 ± 3.33	27.37 ± 2.96	30.28 ± 3.09	0.01

Medical comorbidities
Hypertension, n (%)	48 (73.8)	19 (65.5)	29 (80.6)	0.26	23 (72)	8 (57.1)	15 (83)	0.13
Diabetes, n (%)	21 (32.3)	9 (31)	12 (33.3)	1	16 (50)	6 (42.9)	10 (55.6)	0.72
PAD, n (%)	21 (32.3)	8 (27.6)	13 (36.1)	0.6	11 (34)	6 (42.9)	5 (27.8)	0.47
Stroke, n (%)	5 (7.7)	1 (3.3)	4 (11.1)	0.37	3 (9.4)	0 (0)	3 (16.7)	0.53
COPD, n (%)	12 (18.5)	4 (13.8)	8 (22.2)	0.52	7 (21.9)	2 (14.3)	5 (27.8)	0.43
Renal insufficiency (GFR <60 ml/min), n (%)	44 (67.7)	14 (48.3)	30 (83.3)	0.004	26 (81.3)	11 (78.6)	15 (83.3)	1
Prior CAD, n (%)	26 (40)	10 (34.5)	16 (44.4)	0.45	7 (21.9)	4 (28.6)	3 (16.7)	0.67
Prior MI, n (%)	23 (35.4)	9 (31)	12 (33.3)	1	5 (15.6)	2 (14.3)	3 (16.7)	1
Prior PCI, n (%)	22 (33.8)	9 (31)	13 (36.1)	0.79	2 (6.3)	2 (14.3)	0 (0)	0.18
Prior CABG, n (%)	9 (13.8)	3 (10.3)	6 (16.7)	0.72	2 (6.3)	2 (14.3)	0 (0)	0.18
Charlson comorbidity index (age-adjusted)	4.42 ± 2.93	2.64 ± 1.81	5.81 ± 2.9	<0.001	4.03 ± 2.82	2.86 ± 2.18	4.94 ± 2.98	<0.001

Cardiac arrest variables
Witnessed arrest, n (%)	47 (72.3)	21 (72.4)	26 (72.2)	1	20 (62.5)	10 (71.4)	10 (55.6)	0.47
Shockable rhythm (VT or VF), n (%)	42 (64.6)	25 (86.2)	17 (47.2)	0.002	19 (59.4)	10 (71.4)	9 (50)	0.29
No-flow time (min)	4 [1.5–7]	2 [0–4.5]	6 [3–10]	0.0005	3.5 [2–6]	2 [1–4]	4.5 [3–10]	0.005
Low-flow time (min)	24.23 ± 13.86	19.03 ± 11.55	28.42 ± 14.29	0.0057	27.94 ± 15.58	23.71 ± 10.78	31.22 ± 18.11	0.18
Bystander CPR, n (%)	42 (64.6)	21 (72.4)	21 (58.3)	0.3	19 (59.4)	10 (71.4)	9 (50)	0.29
Number of electric shocks, median (IQR)	3 [1–5]	3 [2–6]	2.5 [0–4.75]	0.11	3 ± 2.72	4 ± 2.42	1 [0–5]	0.05
Epinephrine during resuscitation, n (%)	58 (89.2)	24 (82.8)	34 (94.4)	0.23	32 (100)	14 (100)	18 (100)	1
Total epinephrine dose during resuscitation (mg)	4 [1.9–6]	2 [1–5]	4 [2–6.5]	0.06	4 [3–6]	5 [3–6]	4 [2.75–6]	0.29
Time till ROSC (min)	28.71 ± 14.88	21.76 ± 11.74	34.31 ± 14.91	0.0005	28 [22.5–34]	27 [18–28]	33 [28–59]	0.008
Traumatic injuries on admission, n (%)	30 (46.2)	15 (51.7)	15 (41.7)	0.46	14 (43.8)	6 (42.9)	8 (44.4)	1

Catecholamines
Inotropes (dobutamine), n (%)	51 (78.5)	25 (86.2)	26 (72.2)	0.23	24 (75)	12 (85.7)	12 (66.7)	0.41
Dobutamine (μg/kg/min)	4.384 [0–6.41]	5.13 [3.39–6.31]	2.6 [0–7.1]	0.1	5.42 ± 1.6	5.4 ± 1.1	5.46 ± 2.03	0.97
Norepinephrine, n (%)	65 (100)	29 (100)	36 (100)	1	32 (100)	14 (100)	18 (100)	1
Norepinephrine (μg/kg/min)	0.42 ± 0.25	0.33 ± 0.28	0.49 ± 0.21	0.01	0.36 ± 0.13	0.29 ± 0.16	0.41 ± 0.1	0.01
Epinephrine, n (%)	13 (20)	3 (10.3)	10 (27.8)	0.12	8 (25)	4 (28.6)	5 (27.8)	1
Epinephrine (μg/kg/min)	0.12 ± 0.04	0.04 ± 0.03	0.18 ± 0.07	<0.001	0.65 ± 0.25	0.52 ± 0.19	0.76 ± 0.26	0.17
Mechanical ventilation, n (%)	65 (100)	29 (100)	36 (100)	1	32 (100)	14 (100)	18 (100)	1

Hemodynamic variables on admission
Heart rate (bpm)	88.27 ± 22.27	81.43 ± 20.36	93.58 ± 22.51	0.03	98.31 ± 17.80	98.29 ± 19.55	98.33 ± 16.89	0.99
Systolic arterial pressure (mmHg)	97.44 ± 24.30	100.9 ± 24.42	94.75 ± 24.20	0.32	98.63 ± 13.30	93.29 ± 18.12	102.8 ± 5.48	0.04
Diastolic blood pressure (mmHg)	55.31 ± 13.71	57.86 ± 15.66	53.33 ± 11.83	0.19	58.47 ± 7.74	57.57 ± 10.65	59.17 ± 4.62	0.57
Mean blood pressure (mmHg)	69.35 ± 16.21	72.20 ± 17.37	67.14 ± 15.12	0.22	71.85 ± 8.85	69.48 ± 12.46	73.70 ± 3.98	0.18

Blood values on admission
Lactate (mmol/L)	8.64 ± 3.96	5.89 ± 3.19	10.6 ± 3.57	<0.001	8.29 ± 2.49	6.77 ± 2.52	9.47 ± 1.75	0.001
Creatinine (mg/dl)	1.51 ± 0.50	1.24 ± 0.36	1.69 ± 0.5	0.0043	1.59 ± 0.53	1.33 ± 0.13	1.73 ± 0.62	0.05
GFR (ml/min)	49.26 ± 20.20	62.53 ± 20.63	40.61 ± 14.74	0.005	43.04 ± 14.06	51.56 ± 13.05	38.78 ± 12.83	0.03
Baseline LVEF (%)	32.19 ± 7.32	31.86 ± 7.55	32.35 ± 6.93	0.79	31.07 ± 7.35	34.45 ± 5.02	28.45 ± 7.92	0.02
STEMI at presentation, n (%)	35 (53.8)	19 (65.5)	16 (44.4)	0.13	16 (50)	10 (71.4)	6 (33.3)	0.07
Prehospital thrombolysis, n (%)	9 (13.8)	4 (13.8)	5 (13.9)	1	5 (15.6)	2 (14.3)	3 (16.7)	1
Duration of ICU stay, days	9.11 ± 7.23	14.5 ± 5.02	2 [1–6.75]	<0.001	11.25 ± 7.34	14.71 ± 6.32	8 [1–17]	0.05
Duration of hospital stay, days	9.97 ± 8.07	16.46 ± 5.37	2 [1–6.75]	<0.001	11.50 ± 7.54	15.29 ± 6.51	8 [1–17]	0.02

Scores on admission
SAPS II	79.83 ± 7.83	76.66 ± 6.3	82.39 ± 8.08	0.003	79.5 ± 9.41	75.14 ± 10.36	82.89 ± 7.18	0.02
SOFA	11.57 ± 1.94	11.07 ± 2.1	11.97 ± 1.72	0.06	11.13 ± 2.41	10.86 ± 3.39	11.33 ± 1.28	0.59
IABP	3.59 ± 1.44	2.93 ± 1.39	4.11 ± 1.26	0.001	3.84 ± 1.22	3.36 ± 1.28	4.22 ± 1.06	0.04
APACHE II	33.17 ± 5.65	30.41 ± 5.34	35.39 ± 4.92	<0.001	34.84 ± 4.06	32.86 ± 3.11	36.39 ± 4.1	0.01
CardShock	6.4 ± 1.344	5.66 ± 1.29	7 ± 1.07	<0.001	6.56 ± 1.08	6.14 ± 1.35	6.9 ± 0.68	0.05
ENCOURAGE	25.46 ± 6.44	21.72 ± 6.6	28.47 ± 4.69	<0.001	27.63 ± 4.77	25.14 ± 4.13	29.56 ± 4.41	0.007
SAVE	−5.88 ± 4.94	−3.23 ± 4.35	−7.97 ± 4.39	<0.001	−7 ± 3.61	−4.29 ± 1.82	−9.11 ± 3.23	<0.001

BMI: body mass index; PAD: peripheral artery disease; COPD: chronic obstructive pulmonary disease; GFR: glomerular filtration rate; PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft; VT: ventricular tachycardia; VF: ventricular fibrillation; CPR: cardiopulmonary resuscitation; ROSC: return of spontaneous circulation; LVEF: left ventricular ejection fraction; STEMI: ST-elevation myocardial infarction; ICU: intensive care unit; SAPS II: simplified acute physiology score II; SOFA: sequential organ failure assessment; IABP: intra-aortic balloon pump; APACHE: acute physiology and chronic health; ENCOURAGE: prediction of cardiogenic shock outcome for AMI patients salvaged by VA-ECMO; SAVE: survival after venoarterial extracorporeal membrane oxygenation (VA-ECMO). Numbers are presented as mean (±standard deviation) or median (interquartile range, IQR 25^th–75^th percentile) or frequency (percentile).