Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock

Vikas Singh, Rodrigo Mendirichaga, Parth Bhatt, Ghanshyambhai Savani, Anil K. Jonnalagadda, Igor Palacios, Mauricio G. Cohen, William W. O'Neill

Research output: Contribution to journalArticle

Abstract

Risk-averse behavior has been reported among physicians and facilities treating cardiogenic shock in states with public reporting. Our objective was to evaluate if public reporting leads to a lower use of mechanical circulatory support in cardiogenic shock. We conducted a retrospective study with the use of the National Inpatient Sample from 2005 to 2011. Hospitalizations of patients ≥18 years old with a diagnosis of cardiogenic shock were included. A regional comparison was performed to identify differences between reporting and nonreporting states. The main outcome of interest was the use of mechanical circulatory support. A total of 13043 hospitalizations for cardiogenic shock were identified of which 9664 occurred in reporting and 3379 in nonreporting states (age 69.9 ± 0.4 years, 56.8% men). Use of mechanical circulatory support was 32.8% in this high-risk population. Odds of receiving mechanical circulatory support were lower (OR 0.50; 95% CI 0.43-0.57; p<0.01) and in-hospital mortality higher (OR 1.19; 95% CI 1.06-1.34; p<0.01) in reporting states. Use of mechanical circulatory support was also lower in the subgroup of patients with acute myocardial infarction and cardiogenic shock in reporting states (OR 0.61; 95% CI 0.51-0.72; p<0.01). In conclusion, patients with cardiogenic shock in reporting states are less likely to receive mechanical circulatory support than patients in nonreporting states.

Original languageEnglish (US)
Article number3276521
JournalJournal of Interventional Cardiology
Volume2019
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Cardiogenic Shock
Hospitalization
Hospital Mortality
Inpatients
Retrospective Studies
Myocardial Infarction
Physicians
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Singh, V., Mendirichaga, R., Bhatt, P., Savani, G., Jonnalagadda, A. K., Palacios, I., ... O'Neill, W. W. (2019). Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock. Journal of Interventional Cardiology, 2019, [3276521]. https://doi.org/10.1155/2019/3276521

Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock. / Singh, Vikas; Mendirichaga, Rodrigo; Bhatt, Parth; Savani, Ghanshyambhai; Jonnalagadda, Anil K.; Palacios, Igor; Cohen, Mauricio G.; O'Neill, William W.

In: Journal of Interventional Cardiology, Vol. 2019, 3276521, 01.01.2019.

Research output: Contribution to journalArticle

Singh, Vikas ; Mendirichaga, Rodrigo ; Bhatt, Parth ; Savani, Ghanshyambhai ; Jonnalagadda, Anil K. ; Palacios, Igor ; Cohen, Mauricio G. ; O'Neill, William W. / Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock. In: Journal of Interventional Cardiology. 2019 ; Vol. 2019.
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abstract = "Risk-averse behavior has been reported among physicians and facilities treating cardiogenic shock in states with public reporting. Our objective was to evaluate if public reporting leads to a lower use of mechanical circulatory support in cardiogenic shock. We conducted a retrospective study with the use of the National Inpatient Sample from 2005 to 2011. Hospitalizations of patients ≥18 years old with a diagnosis of cardiogenic shock were included. A regional comparison was performed to identify differences between reporting and nonreporting states. The main outcome of interest was the use of mechanical circulatory support. A total of 13043 hospitalizations for cardiogenic shock were identified of which 9664 occurred in reporting and 3379 in nonreporting states (age 69.9 ± 0.4 years, 56.8{\%} men). Use of mechanical circulatory support was 32.8{\%} in this high-risk population. Odds of receiving mechanical circulatory support were lower (OR 0.50; 95{\%} CI 0.43-0.57; p<0.01) and in-hospital mortality higher (OR 1.19; 95{\%} CI 1.06-1.34; p<0.01) in reporting states. Use of mechanical circulatory support was also lower in the subgroup of patients with acute myocardial infarction and cardiogenic shock in reporting states (OR 0.61; 95{\%} CI 0.51-0.72; p<0.01). In conclusion, patients with cardiogenic shock in reporting states are less likely to receive mechanical circulatory support than patients in nonreporting states.",
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