Dobutamine Infusion and Absence of Pulmonary Hypertension Are Associated with Decreased Mortality in a Cohort of 249 Patients with Cardiogenic Shock

Abstract

Objective: Prognostic analysis of 249 patients admitted for cardiogenic shock (CS) of various origins. Background: Little is known about prognosis of CS from non-ischemic cardiomyopathy. Methods: Retrospective monocentric study of patients referred to an ICU during 2 years. Results: Despite aggressive management including intra-aortic balloon pump (31%), extra-renal replacement therapy (36%), extra-corporeal life support (8%), and catecholamine infusion (97%), in-hospital mortality was 46%. Toxic CS or CS related to deficiency carried a better outcome (mortality 5%). Post-myocardial infarction or post-cardiac arrest CS was associated with higher mortality. In the multivariate analyses, only SAPS II (OR 1.037; 1.013 - 1.056; p = 0.0001), pulmonary hypertension (OR 4.8; 1.3 - 17; p = 0.02), extra-renal replacement therapy (OR 2.9; 1.3 - 6; p = 0.006), and dobutamine infusion (OR 0.44; 0.2 - 0.96; p = 0.04) were significantly associated with in-hospital mortality. Conclusion: Dobutamine infusion was associated with a better outcome. Higher SAPS II, pulmonary hypertension, and extra-renal replacement therapy were associated with increased in-hospital mortality.