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

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Kataja , A , Tarvasmäki , T , Lassus , J , Kober , L , Sionis , A , Spinar , J , Parissis , J , Carubelli , V , Cardoso , J , Banaszewski , M , Marino , R , Nieminen , M S , Mebazaa , A & Harjola , V-P 2018 , ' Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study ' , European Heart Journal: Acute Cardiovascular Care , vol. 7 , no. 1 , pp. 38-44 . https://doi.org/10.1177/2048872617702505

Title: Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study
Author: Kataja, Anu; Tarvasmäki, Tuukka; Lassus, Johan; Kober, Lars; Sionis, Alessandro; Spinar, Jindrich; Parissis, John; Carubelli, Valentina; Cardoso, Jose; Banaszewski, Marek; Marino, Rossella; Nieminen, Markku S.; Mebazaa, Alexandre; Harjola, Veli-Pekka
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Clinicum
University of Helsinki, HUS Emergency Medicine and Services
Date: 2018-02
Number of pages: 7
Belongs to series: European Heart Journal: Acute Cardiovascular Care
ISSN: 2048-8726
URI: http://hdl.handle.net/10138/299682
Abstract: 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 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.
Subject: Cardiogenic shock
acute coronary syndromes
acute heart failure
altered mental status
delirium
acidosis
CRITICALLY-ILL PATIENTS
INTENSIVE-CARE-UNIT
RISK-FACTORS
HEART-FAILURE
DELIRIUM
OUTCOMES
METAANALYSIS
ASSOCIATION
PREVALENCE
MANAGEMENT
3121 Internal medicine
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