Predictive Nomogram of the in-Hospital Mortality of Patients with Cardiogenic Shock

Abstract

BackgroundDespite advances in treatment, the mortality rates of patients with cardiogenic shock (CS) remain high. The aim of this study was to develop a risk-predictive model for in-hospital mortality in patients admitted to the cardiac care unit (CCU) because of CS. Methods This retrospective study enrolled 509 adult patients who received inotropic support at the emergency room with subsequent admission to the CCU from January 2017 to December 2019. Patients with out-of-hospital cardiac arrest, inotrope use for conduction disorders, and non-CS were excluded. A total of 246 patients were analyzed using multiple logistic regression. ResultsA history of coronary artery disease (OR 3.44), multiple inotropic use (OR 17.70), ejection fraction less than 40% (OR 0.27), longer cardiopulmonary resuscitation (CPR) duration (OR 1.11), albumin infusion (OR 4.66), and renal replacement therapy (OR 3.08) were associated with higher in-hospital mortality. These factors were used to develop a risk-predictive nomogram. A receiver operating characteristic (ROC) curve was drawn using scores from 0 to 198.5 (area under the curve [AUC] = 0.92), and the cut-off score of 65 was identified. The model accurately predicted mortality (AUC = 0.81) in a validation set of 68 patients, with a sensitivity of 81% and a specificity of 74%. Conclusion Factors were used to develop a highly accurate risk-predictive nomogram for the in-hospital mortality of patients with CS, which may aid physicians in making prognoses.