ArticleClinical cardiology2026
Association of Mechanical Circulatory Support With In-Hospital Outcomes in Non-Ischemic Cardiogenic Shock: A Nationwide Inpatient Study.
Article in Clinical cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionCardiogenic shock (CS) carries high morbidity and mortality. However, evidence for mechanical circulatory support (MCS) in non-ischemic CS remains limited, as prior trials have focused on infarct-related shock.
methodsWe performed a retrospective cross-sectional study using the Nationwide Inpatient Sample (2017-2019), identifying hospitalizations with a principal diagnosis of CS and excluding acute myocardial infarction. Patients were categorized into mutually exclusive groups: no MCS, intra-aortic balloon pump (IABP) only, Impella only, or extracorporeal membrane oxygenation (ECMO) only. Primary outcomes were in-hospital mortality, length of stay (LOS), and total hospital cost. Survey-weighted multivariable models adjusted for demographics, hospital characteristics, and comorbidity burden using Elixhauser and Charlson indices.
resultsAmong 104 045 hospitalizations, 6040 received MCS. IABP was most common, followed by Impella and ECMO. Among patients receiving a single MCS strategy, overall in-hospital mortality was 29.5%., with lower mortality in the IABP group (19.9%) compared with Impella (37.4%) and ECMO (44.3%). After adjustment, IABP was associated with lower observed in-hospital mortality versus no MCS (aOR 0.58, 95% CI 0.53-0.64; p < 0.01), whereas Impella and ECMO showed increased aOR. IABP and ECMO were associated with longer LOS, while Impella was not. All MCS strategies were associated with higher costs, with ECMO showing the greatest increase (cost ratio 3.30, 95% CI 3.12-3.50).
conclusionIn non-ischemic CS, MCS strategies demonstrate distinct profiles of mortality and resource utilization. IABP was associated with lower observed in-hospital mortality, whereas all MCS were linked to higher costs, highlighting heterogeneity in outcomes and the need for further research.
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