Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F18%3A00069781" target="_blank" >RIV/65269705:_____/18:00069781 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/18:00104070

Result on the web

<a href="http://dx.doi.org/10.1177/2048872617702505" target="_blank" >http://dx.doi.org/10.1177/2048872617702505</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1177/2048872617702505" target="_blank" >10.1177/2048872617702505</a>

Result language

angličtina

Original language name

Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study

Original language description

Background: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. Methods: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study. Clinical picture, biochemical variables, and short-term mortality were compared between patients presenting with altered and normal mental status. Results: Altered mental status was detected in 147 (68%) patients, whereas 68 (32%) patients had normal mental status. Patients with altered mental status were older (68 vs. 64 years, p=0.04) and more likely to have an acute coronary syndrome than those with normal mental status (85% vs. 74%, p=0.04). Altered mental status was associated with lower systolic blood pressure (76 vs. 80 mmHg, p=0.03) and lower arterial pH (7.27 vs. 7.35, p&lt;0.001) as well as higher levels of blood lactate (3.4 vs. 2.3 mmol/l, p&lt;0.001) and blood glucose (11.4 vs. 9.0 mmol/l, p=0.01). Low arterial pH (adjusted odds ratio 1.6 (1.1-2.2), p=0.02) was the only factor independently associated with altered mental status. Ninety-day mortality was significantly higher (51% vs. 22%, p&lt;0.001) among patients with altered mental status. Conclusions: Altered mental status is a common clinical sign of systemic hypoperfusion in cardiogenic shock and is associated with poor outcome. It is also associated with several biochemical findings that reflect inadequate tissue perfusion, of which low arterial pH is independently associated with altered mental status.

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

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

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

European heart journal: Acute cardiovascular care

ISSN

2048-8726

e-ISSN

—

Volume of the periodical

7

Issue of the periodical within the volume

1

Country of publishing house

GB - UNITED KINGDOM

Number of pages

7

Pages from-to

38-44

UT code for WoS article

000424643000005

EID of the result in the Scopus database

2-s2.0-85050193151