2016 Volume 80 Issue 4 Pages 852-859
Background:There are little data about cardiovascular shock caused by various diseases. We evaluated the characteristics and predictors of 30-day mortality in patients with cardiovascular shock in Japan.Methods and Results:The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 979 patients with cardiovascular shock were analyzed. The primary endpoint was 30-day all-cause mortality. The mean systolic blood pressure on hospital arrival was 78±18 mmHg. The main causes of shock were acute coronary syndrome (51.0%), non-ischemic arrhythmia (16.4%), and aortic disease (14.9%). The 30-day all-cause mortality was 34.3%. After adjustment for independent predictors of 30-day mortality, the odds ratios for systolic blood pressure (per 10-mmHg decrease), consciousness disturbance, congestive heart failure, out-of-hospital cardiac arrest, estimated glomerular filtration rate (per 10-ml/min/1.73 m2decrease), and causes of shock (non-ischemic arrhythmia, aortic disease, and myocarditis) were 1.15 (95% confidence interval [CI], 1.08–1.22), 2.62 (95% CI, 1.80–3.82), 2.58 (95% CI, 1.67–3.99), 1.62 (95% CI, 1.05–2.51), 1.20 (95% CI, 1.10–1.30), and 0.48 (95% CI, 0.30–0.77), 3.98 (95% CI, 2.32–6.81), and 3.25 (95% CI, 1.20–8.84), respectively.Conclusions:The 30-day mortality for cardiovascular shock was still high at 34%. Primary predictors of mortality were cardiorenal function on hospital arrival and shock etiology. (Circ J 2016; 80: 852–859)
