Cardiac Shock in Patients Hospitalized for Acute Myocardial Infarction

Endurance O. Evbayekha^1*, Bede N. Nriagu², Evidence E. Ohikhuai³ , Emeka C. Ibeson⁴, Faithful T. Ogundiran⁵, Nkemputaife P. Onyechi⁶, Uchechukwu O. Ogbonna⁷, Omotola Akinade⁸, Nneka J. Umeh⁹, Ekene Ilechie¹⁰, Adewale M. Adedoyin¹¹, Kelechim N. Diorgu¹², Chinedum I. Iluno¹³, Joy Iroro¹⁴, Adebola E. Omogunwa¹⁵, Okelue E. Okobi¹⁶

Abstract

Introduction: There is a paucity of data on in-hospital outcomes and mortality in individuals with myocardial infarction (MI) complicated by cardiogenic shock (CS). However, this complication greatly affects prognosis amongst other factors and is a fairly common concern. We aim to add to the existing body of knowledge in this regard. Methods and Results: Patients with MI admitted from January 1, 2005, to December 31, 2014, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the population and selected subgroups. Among 73,573,571 hospitalizations spanning from January 1, 2005, to December 31, 2014, 1,208,029 (1.65%) were attributed to MI. Of these, the number of hospitalized individuals admitted primarily for myocardial infarction with a secondary diagnosis of CS (MICS) was 60,661 (5.02%), 62% (37,885) of which were men. The prevalence by racial ethnicity was 76.13% (39,282) whites, 7.51% (3873) blacks, and (4239) 8.22% Asians. The mean age of all affected with MICS was 68.6 years (SD=13.2). The mortality outcome of the 60661 affected was 21283, i.e., 35.10% mortality. There has been a steady increase in hospitalizations in individuals with myocardial infarction and a secondary diagnosis of cardiogenic shock from 68 per 100 000 hospitalizations in 2005 to 103 per 100 000 hospitalizations in 2014 (p =0.001), it showed 9% vs. 12.2% increase (p =0.001). Of the people that died from MICS, 76.30% (13,754) were white, and Asians and blacks were 8.38% (1,510) and 7.54% (1,359). However, there was no statistical significance in racial differences as p =0.33. Mortality across the various hospital regions showed no statistical significance, p =0.88. However, the mortality among patients with MICS in the in-hospital setting decreased (from 40.80% (2226/5456) in 2005 to 33.70% (2456/7288) in 2014; p =0.001). The mean length of stay (LOS) trend decreased from 9.14 days (SD=10.6) in 2010 to 8.88 days (SD=10.6) in 2013 (p =0.001). There was, however, an upsurge in total hospital charges (CRG) from $147,727 (SD=153,847) in 2010 to $172,357 (SD=201,168) in 2013 (p =0.001). Weekend or weekday admission showed no significant difference in mortality outcome, 73.01% (44,263) vs. 26.99% (16,363) (p =0.18). The adjusted rate for mortality by month revealed that there was a significant increase in in-hospital mortality in December and January (p =0.005). There was a significant difference among patients with congestive cardiac failure (CCF), p =0.001, but type 2 diabetes (T2DM) did not significantly affect the mortality outcomes of these patients. Conclusions: Hospitalizations attributed to MICS rose significantly from January 2005 to December 2014. Our study delineated a decline in MICS in-hospital mortality during this period. Furthermore, a general increase in mortality during December and January was observed in the studied population.

Keywords

cardiac shock; acute myocardial infarction; patients hospitalized

Cite This Article

Evbayekha, E. O., Nriagu, B. N., Ohikhuai, E. E., Ibeson, E. C., Ogundiran, F. T., Onyechi, N. P., Ogbonna, U. O., Akinade, O., Umeh, N. J., Ilechie, E., Adedoyin, A. M., Diorgu, K. N., Iluno, C. I., Iroro, J., Omogunwa, A. E., Okobi, O. E. (2022). Cardiac Shock in Patients Hospitalized for Acute Myocardial Infarction. International Journal of Scientific Advances (IJSCIA), Volume 3| Issue 5: Sep-Oct 2022, Pages 730-735, URL: https://www.ijscia.com/wp-content/uploads/2022/09/Volume3-Issue5-Sep-Oct-No.341-730-735.pdf

Volume 3 | Issue 5: Sep-Oct 2022