(249) Postoperative Cardiogenic Shock Outcomes in Patients With Sepsis With Shock

Introduction: Septic shock is a critical condition with high morbidity and mortality, especially when complicated by cardiogenic shock (CS). This study aims to compare demographic, clinical, and outcome characteristics between septic shock patients with cardiogenic shock and those with postoperative cardiogenic shock (Postop CS).

Methods: We conducted a retrospective analysis using the National Inpatient Sample (NIS) database from 2016 to 2021, including a total weighted sample size of 208,290 septic shock patients with cardiogenic shock. Patients were categorized into CS (n=204,945, 98.4%) and Postop CS (n=3,345, 1.6%).

Results: The study included 208,290 septic shock patients with cardiogenic shock, of which 204,945 (98.4%) had CS and 3,345 (1.6%) had Postop CS. The Postop CS group had a higher proportion of males (67.1% vs. 60.1%, p< 0.001) and a slightly lower median age (67 vs. 68 years, p=0.002). Postop CS patients had a significantly longer median length of stay (24 vs. 10 days, p< 0.001). Differences in primary insurance, hospital region, location, teaching status, and bed size were significant, with Postop CS patients more likely to be in urban teaching hospitals (90.7% vs. 81.3%, p< 0.001) and large hospitals (77.6% vs. 60.9%, p< 0.001). Comorbidities such as hyperlipidemia, hypertension, prior myocardial infarction, prior pacemaker/defibrillator use, smoking, COPD, prior stroke, liver disease, diabetes, hypothyroidism, nutritional anemia, UTI, and COVID-19 differed significantly between groups. In-hospital mortality was slightly higher in Postop CS patients (52.9% vs. 49.3%, p=0.082). Multivariate analysis revealed that Postop CS was associated with a higher mortality risk (OR 1.87, p< 0.001), as were older age, Black, Hispanic, and Asian or Pacific Islander races, liver disease, CKD/ESRD, diabetes, and COVID-19, while hyperlipidemia, chronic heart failure, smoking, UTI, and anemia were associated with decreased mortality.

Conclusions: Septic shock patients with postoperative cardiogenic shock exhibit distinct demographic and clinical characteristics and experience longer hospital stays compared to those with cardiogenic shock. Mortality is significantly higher in postoperative cardiogenic shock, emphasizing the need for targeted interventions and resource allocation for this high-risk group.