Fifteen-year trends in incidence of cardiogenic shock hospitalization and in-hospital mortality in the united states

Abstract

BACKGROUND: There is a lack of contemporary data on cardiogenic shock (CS) in-hospital mortality trends. METHODS AND RESULTS: Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the overall population and selected subgroups. Among a total of 563 949 644 hospitalizations during the period from January 1, 2004, to December 30, 2018, 1 254 358 (0.2%) were attributed to CS. There has been a steady increase in hospitalizations attributed to CS from 122 per 100 000 hospitalizations in 2004 to 408 per 100 000 hospitalizations in 2018 (Ptrend <0.001). This was associated with a steady decline in the adjusted trends of in-hospital mortality during the study period in the overall population (from 49% in 2004 to 37% in 2018; Ptrend <0.001), among patients with acute myocardial infarction CS (from 43% in 2004 to 34% in 2018; Ptrend <0.001), and among patients with non–acute myocardial infarction CS (from 52% in 2004 to 37% in 2018; Ptrend <0.001). Consistent trends of reduced mortality were seen among women, men, different racial/ethnic groups, different US regions, and different hospital sizes, regardless of the hospital teaching status. CONCLUSIONS: Hospitalizations attributed to CS have tripled in the period from January 2004 to December 2018. However, there has been a slow decline in CS in-hospital mortality during the studied period. Further studies are necessary to determine if the recent adoption of treatment algorithms in treating patients with CS will further impact in-hospital mortality.