Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock
Recommended Citation
Singh V, Mendirichaga R, Bhatt P, Savani G, Jonnalagadda AK, Palacios I, Cohen MG, and O'Neill WW. Association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock. J Interv Cardiol 2019; 2019.
Document Type
Article
Publication Date
10-2019
Publication Title
J Interv Cardiol
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.
PubMed ID
31772523
Volume
2019
