| アブストラクト | Little is known about the impact of the downgrade of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella in Japan, where IABPs have been predominantly used. This study aimed to describe the annual trends in the mechanical circulatory support (MCS) use and outcomes in patients with cardiogenic shock (CS) requiring MCS. Using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2021, we identified inpatients with CS requiring MCS. The patients were stratified into 3 groups: (1) IABP alone, (2) Impella alone, and (3) extracorporeal membrane oxygenation (ECMO), regardless of IABP or Impella use. The patient characteristics and outcomes were reported by the fiscal year. Of the 160,559 eligible patients, 117,599 (73.2%) used IABP alone, 1,465 (0.9%) Impella alone, and 41,495 (25.8%) ECMO. The prevalence of the use of an IABP alone significantly decreased from 80.5% in 2010 to 65.3% in 2020 (p for trend <0.001), whereas the prevalence of the use of an Impella alone significantly increased from 0.0% to 5.0% and ECMO from 19.5% to 29.6% (p for trend <0.001 for both). In-hospital mortality significantly increased from 29.3% in 2010 to 32.6% in 2020 in the overall patients with CS requiring MCS but significantly decreased in those requiring ECMO from 73.7% to 64.1% (p for trend <0.001 for both). In conclusion, there were significant annual changes in the patterns of MCS use and clinical outcomes in patients with CS requiring MCS. |
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| ジャーナル名 | The American journal of cardiology |
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| 投稿日 | 2023/7/28 |
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| 投稿者 | Nishimoto, Yuji; Ohbe, Hiroyuki; Matsui, Hiroki; Nakata, Jun; Takiguchi, Toru; Nakajima, Mikio; Sasabuchi, Yusuke; Sato, Yukihito; Watanabe, Tetsuya; Yamada, Takahisa; Fukunami, Masatake; Yasunaga, Hideo |
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| 組織名 | Division of Cardiology, Osaka General Medical Center, Osaka, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. Electronic address:;hohbey@gmail.com.;Health, The University of Tokyo, Tokyo, Japan.;Division of Cardiovascular Intensive Care and.;Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo,;Japan.;Health, The University of Tokyo, Tokyo, Japan; Emergency Life-Saving Technique;Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo, Japan.;Data Science Center, Jichi Medical University, Tochigi, Japan.;Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center,;Amagasaki, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37499600/ |
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