Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F18%3A00068770" target="_blank" >RIV/65269705:_____/18:00068770 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/18:00104160

Result on the web

<a href="http://dx.doi.org/10.1007/s00134-018-5222-9" target="_blank" >http://dx.doi.org/10.1007/s00134-018-5222-9</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00134-018-5222-9" target="_blank" >10.1007/s00134-018-5222-9</a>

Result language

angličtina

Original language name

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Original language description

Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]). In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Intensive care medicine

ISSN

0342-4642

e-ISSN

—

Volume of the periodical

44

Issue of the periodical within the volume

6

Country of publishing house

US - UNITED STATES

Number of pages

10

Pages from-to

847-856

UT code for WoS article

000435995400012

EID of the result in the Scopus database

2-s2.0-85047904126