Abstract 12839: A Standardized and Regionalized System of Care Network for Cardiogenic Shock: Insights From the Inova-Shock Registry

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-11, Vol.144 (Suppl_1), p.A12839-A12839
• Main Authors: Tehrani, Behnam N, Sherwood, Matthew W, Rosner, Carolyn, Baghchi, Pramita, Truesdell, Alexander G, Bakhshi, Hooman, Damluji, Abdulla, desai, mehul, Desai, Shashank, Epps, Kelly C, Flanagan, Michael, Gattani, Raghav, Genovese, Leonard, Howard, Edward, Ibrahim, Nasrien, Kasarabada, Aditya, Kennedy, Jamie, Lantry, James, Moukhachen, Hala, Ofosu-Somuah, Araba, Petro, Kathleen, Psotka, Mitchell, Qion, Xaioxiao, Ryan, Liam, Sarin, Eric, Shah, Palak, Singh, Ramesh, Sinha, Shashank, Speir, Alan, Tang, Daniel, Welch, Timothy, Young, Karl, Defilippi, Christopher, O'Connor, Christopher M, Batchelor, Wayne B
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.12839

IntroductionRecent studies have demonstrated improved short-term outcomes with cardiogenic shock (CS) at centers using standardized protocols. Whether these benefits may be extended across systems of care networks is unknown. ObjectiveTo investigate clinical characteristics & short-term outcomes of CS patients initially managed at spoke hospitals & transferred, & those admitted directly to the hub. MethodsObservational study of 520 consecutive CS patients (1/3/2017-12/31/2019) treated in a regionalized network of 34 spoke hospitals across 600 sq miles. Presenting location, clinical characteristics, mechanical circulatory support (MCS) use & outcomes were compared. Multivariate logistic regression was employed to determine factors associated with 30-day mortality. ResultsFifty five percent (n=287) initially presented to a spoke. They were more likely to have CS due to acute myocardial infarction (50.5% vs 31.8%; p< 0.01) & be supported initially with an IABP (32.1% 17.2%; p2.0 mg/dL & index SCAI shock stages D & E. Initial presentation to a spoke was not (aOR 0.81; 95% CI 0.49-0.38; p=0.38 ) ConclusionsDespite differences in CS etiology and initial MCS use, the hub and spoke cohorts had similar 30-day mortality & associated short-term outcomes. Creating a regionalized system of CS care across a multi-hospital network with dedicated protocols & expedited transfer algorithms may provide similar benefits for patients initially presenting to either hub or spoke shock care centers.