(1591) Descriptive Analysis and Mortality Predictors in Cardiogenic Shock Patients With Septic Shock

Introduction: Cardiogenic shock (CS) and septic shock (SS) represent critical conditions with high mortality rates, often co-existing and complicating patient outcomes. This study aims to provide a descriptive analysis of patients with CS, comparing those with concomitant SS (CS+SS) to those with CS alone (CS only), and to identify predictors of in-hospital mortality using logistic regression analysis.

Methods: A retrospective analysis was performed on NIS dataset comprising 1,103,390 patients with CS, of which 208,290 (18.9%) had concomitant SS. Descriptive statistics were used to compare demographic, clinical, and hospital characteristics between the two groups.

Results: Among the cohort, 60.2% of CS+SS patients were male, compared to 63.2% in the CS only group (p < 0.001). The median length of stay was significantly longer in the CS+SS group (10 days, IQR 4-19) than in the CS only group (7 days, IQR 3-14) (p < 0.001). Significant differences were observed in race, with a higher proportion of Black (17.4% vs. 15.7%, p < 0.001) and Hispanic patients (10.6% vs. 8.8%, p < 0.001) in the CS+SS group. Regarding comorbidities, CS+SS patients had higher rates of liver disease (34.1% vs. 21.6%, p < 0.001) and chronic kidney disease/ESRD (46.6% vs. 41.5%, p < 0.001). Notably, CS+SS patients had a significantly higher incidence of in-hospital mortality (49.4% vs. 29.0%, p < 0.001).
Logistic regression identified several significant predictors of in-hospital mortality in CS patients:
- Female sex (Adjusted OR 1.159, 95% CI 1.134-1.184, p < 0.001)
- Age ≥65 years (Adjusted OR 2.078, 95% CI 1.989-2.172, p < 0.001)
- Black race (Adjusted OR 1.072, 95% CI 1.038-1.108, p < 0.001)
- Liver disease (Adjusted OR 1.982, 95% CI 1.933-2.031, p < 0.001)
- COVID-19 infection (Adjusted OR 3.02, 95% CI 2.802-3.256, p < 0.001)
- Pneumonia (Adjusted OR 1.274, 95% CI 1.238-1.31, p < 0.001)

Conclusions: CS patients with concomitant SS exhibit distinct demographic and clinical characteristics, with significantly higher in-hospital mortality. The presence of SS, advanced age, female sex, certain racial backgrounds, and comorbid conditions, including liver disease and COVID-19, are significant mortality predictors. These findings highlight the need for targeted strategies to improve outcomes in this high-risk population.