First SHOCK TEAM in Poland: Single-hub-center experience with multidisciplinary care for cardiogenic shock.

BACKGROUND

Cardiogenic shock (CS) remains a complex syndrome with alarmingly high mortality despite treatment advances.

AIMS: This study aimed to describe the experience of the management of patients with CS according to a standardized multidisciplinary team-based protocols.

MATERIAL AND

METHODS

This is a retrospective analysis of patients with a diagnosis of CS admitted to a large academic tertiary hospital between 2021 and 2023. Patients were managed according to the CS protocols developed at our institution by a dedicated multidisciplinary shock team. We report patients' clinical characteristics, mechanical circulatory support (MCS) utilization, and in-hospital outcomes.

RESULTS

Over the three-year period, we identified 257 patients (median age: 69 years, 69% males). In this cohort, acute coronary syndrome was the most common cause of CS (55% of patients), 17% presented with out-of-hospital cardiac arrest, 18% experienced in-hospital cardiac arrest, and 20% of patients were transferred from remote centers. An MCS system was used in 39% of all patients. In-hospital mortality was 62% with significant improvement in consecutive 1-year periods: 75% in 2021 vs. 69% in 2022 vs. 44% in 2023, respectively, P = 0.004 for trend. This improvement was particularly evident in the group supported with MCS: all-cause mortality: 75% in 2021, 50% in 2022, and 29% in 2023 (P = 0.005). The use of MCS was a significant independent predictor of improved survival in 2022 and 2023 (odds ratio, 0.38; confidence interval, 0.149-0.996; P = 0.04).

CONCLUSIONS

Our results suggest that a standardized multidisciplinary approach incorporating the availability of MCS therapies and heart transplantation may be associated with improved outcomes in patients with CS.