The impact of liver cirrhosis on in-hospital outcomes among patients hospitalized for cardiogenic shock: A propensity score matched retrospective cohort study

Cardiogenic shock poses a critical challenge characterized by diminished cardiac output and organ perfusion. Timely recognition and risk stratification are essential for effective intervention. Liver cirrhosis adds complexity due to its diverse systemic manifestations. The effect of liver cirrhosis...

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Bibliographic Details
Published in:Journal of cardiology 2024-09
Main Authors: Siraw, Bekure B., Ebrahim, Mohamed A., Isha, Shahin, Patel, Parth, Mehadi, Abdulrahim Y., Zaher, Eli A., Tafesse, Yordanos T., Siraw, Biruk
Format: Article
Language:English
Subjects:
Cardiogenic shock
In-hospital outcomes
Liver cirrhosis
National Inpatient Sample
Retrospective cohort study
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Summary:Cardiogenic shock poses a critical challenge characterized by diminished cardiac output and organ perfusion. Timely recognition and risk stratification are essential for effective intervention. Liver cirrhosis adds complexity due to its diverse systemic manifestations. The effect of liver cirrhosis on in-hospital outcomes in cardiogenic shock remains underexplored. We conducted a retrospective cohort study using the National Inpatient Sample database from 2016 to 2020, matching cirrhotic patients with non-cirrhotic counterparts using propensity scores. The Cochran-Mantel-Haenszel method was used to assess the impact of cirrhosis on in-hospital mortality and complications. Simple linear regression models were used to assess differences in length of stay and cost of hospitalization. There was a total of 44,288 patients in the cohort, evenly distributed between the group with and without liver cirrhosis. Mean age of the cohort was 64 years (SD 12.5), 69.7 % were males, and 61.3 % were white. The overall in-hospital mortality rate in the cohort was 37.2 % with higher odds of in-hospital mortality in cirrhotic patients [OR = 1.3; 95 % CI (1.25, 1.35)]. Patients with cirrhosis exhibited increased risks of bowel ischemia, acute kidney injury, and sepsis compared to those without cirrhosis. Additionally, they had a heightened overall risk of major bleeding, particularly gastrointestinal bleeding, but a lower risk of intracranial hemorrhage and access site bleeding. Conversely, patients with cirrhosis had lower odds of deep vein thrombosis and pulmonary embolism, as well as arterial access site thrombosis and dissection, leading to reduced odds of peripheral angioplasty, thrombectomy, and amputation. Cirrhotic patients also had increased length of stay and cost of hospitalization. Liver cirrhosis exacerbates outcomes in cardiogenic shock, necessitating tailored management strategies. Further research is warranted to optimize patient care and understand the underlying mechanisms. [Display omitted] •Liver cirrhosis worsens in-hospital outcomes in cardiogenic shock patients.•Cirrhotic patients show higher in-hospital mortality and complication rates.•Cirrhotic patients experience longer hospital stays and higher hospitalization costs.
ISSN:0914-5087
1876-4738
1876-4738
DOI:10.1016/j.jjcc.2024.09.004