(498) Role of Low Platelets in Cardiogenic Chock: Does It Impact Outcomes?

Introduction: Cardiogenic shock (CS) is a severe condition associated with high mortality. Thrombocytopenia in CS patients can complicate management and outcomes. This study analyzes the impact of thrombocytopenia on the demographics, clinical characteristics, and outcomes of CS patients.

Methods: We used data from the National Inpatient Sample (NIS) for the years 2016-2021, comprising a total weighted sample size of 1,103,390 CS patients. We compared CS patients with thrombocytopenia (N=192,885) to those without (N=910,505) using descriptive statistics and multivariate analysis to assess predictors of in-hospital mortality.

Results: Thrombocytopenia in CS patients was associated with a higher proportion of males (65.5% vs. 62.0%, p< 0.001) and a slightly lower mean age (66.11 vs. 66.41 years, p< 0.001). These patients experienced longer hospital stays (≥7 days: 72.0% vs. 53.6%, p< 0.001). Racial differences were notable, with a higher representation of Asian or Pacific Islanders in the thrombocytopenia group (4.3% vs. 3.2%, p< 0.001). Hospital characteristics showed a higher prevalence of admissions in the Midwest and urban teaching hospitals for thrombocytopenia patients. Thrombocytopenia patients had higher rates of chronic heart failure, hypertension, CKD/ESRD, and liver disease, but lower rates of prior myocardial infarction, PCI, CABG, pacemaker use, and smoking. In-hospital mortality was lower in the thrombocytopenia group (31.0% vs. 33.3%, p< 0.001). However, multivariate analysis identified thrombocytopenia as an independent predictor of increased mortality (Adjusted OR 1.123, p< 0.001). Other significant mortality predictors included female sex, age ≥65, Black race, liver disease, CKD/ESRD, diabetes, and pneumonia. Protective factors included hyperlipidemia, hypertension, chronic heart failure, and smoking.

Conclusions: Thrombocytopenia in CS patients is associated with distinct demographic and clinical profiles, longer hospital stays, and specific comorbidities. Despite a lower unadjusted mortality rate, thrombocytopenia independently predicts higher in-hospital mortality. Understanding these associations can aid in risk stratification and management strategies for CS patients with thrombocytopenia.