ArticlemedRxiv : the preprint server for health sciences2025
Practice Variation in Vasoactive Medication Use for Cardiogenic Shock Across ICU Subtypes: A Retrospective Cohort Study.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundCardiogenic shock has significant associated morbidity and mortality with a wide range of vasoactive management strategies. However, the extent to which variation in vasoactive and inodilator therapies is explained by patient level variables versus clinical practice variation remains underexplored.
methodsThe cohort included 4,525 patients admitted to ICUs at Michigan Medicine from 01/01/2014-12/31/2023 diagnosed with cardiogenic shock identified by billing codes. Vasoactive medication utilization was compared across various ICUs (cardiovascular, cardiovascular surgical, non-cardiac). Mixed-effect multiple logistic modeling was used to evaluate to what extent variation in inodilator use was associated with fixed patient-level variables (i.e. prior cardiac arrest) compared to ICU location as a random effect.
resultsPatient encounters were classified as cardiovascular ICU (n = 1,355), cardiovascular surgical ICU (n = 1,405), non-cardiac ICU (n = 723), and multiple ICUs (n = 1,042). Vasoactive and inodilator medication use varied significantly. Inodilators were more frequently used in the cardiac ICU (44.4% [95% CI 40.4-48.3%]), cardiothoracic surgical ICU (64.9% [61.8-68.0%]), and multiple ICU patients (60.8% [57.0-64.6%]) and less frequently in non-cardiac ICU patients (18.8% [12.2-25.4%]). Heart failure was associated with more frequent inodilator use (OR 3.82 [3.06-4.80]), while increased age (OR 0.993 [0.989 - 0.997]), male sex (0.80 [0.70 - 0.91]), and prior cardiac arrest (0.68 [0.58 - 0.81]) were associated with lower use. ICU location attributed to 15.8% of variance in inodilator use, while fixed patient-level variables combined accounted for 6.1% of variance.
conclusionA substantial portion of variation in vasoactive medication utilization was attributed to ICU setting.
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.