Baseline characteristics, management, and predictors of early mortality in cardiogenic shock: insights from the FRENSHOCK registry

Clément Delmas (1, 2) , François Roubille (3, 4) , Nicolas Lamblin (5, 6) , Laurent Bonello (7, 8, 9) , Guillaume Leurent (10, 11) , Bruno Levy (12, 13, 14) , Meyer Elbaz (15, 2) , Nicolas Danchin (16, 17, 18) , Sebastien Champion (19) , Pascal Lim (20, 21) , Francis Schneider (22, 23) , Alain Cariou (24, 25) , Hadi Khachab (26) , Jérémy Bourenne (27) , Marie‐france Seronde (28) , Guillaume Schurtz (29, 5) , Brahim Harbaoui (30, 31) , Gerald Vanzetto (32, 33) , Charlotte Quentin (34) , Xavier Delabranche (35, 36) , Nadia Aissaoui (16) , Nicolas Combaret (37, 38) , Stéphane Manzo-Silberman (39) , Danka Tomasevic (40) , Benjamin Marchandot (36) , Benoit Lattuca (41, 42, 43) , Patrick Henry (39) , Edouard Gerbaud (44, 45) , Eric Bonnefoy (40) , Etienne Puymirat (16)

1 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
2 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
3 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
4 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
5 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
8 MARS cardio - Mediterranean Association for Research and Studies in Cardiology
9 Hôpital Nord [CHU - APHM]
10 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
11 LTSI - Laboratoire Traitement du Signal et de l'Image
12 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
13 Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]
14 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
15 Institut Cardiomet [CHU Toulouse]
16 HEGP - Hôpital Européen Georges Pompidou [APHP]
17 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
18 FACT - Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials
19 Hôpital privé de Parly 2 - Ramsay Santé [Le Chesnay-Rocquencourt]
20 IMRB - Institut Mondor de Recherche Biomédicale
21 Hôpital Henri Mondor
22 HUS - Les Hôpitaux Universitaires de Strasbourg
23 BB - Biomatériaux et Bioingénierie
24 Hôpital Cochin [AP-HP]
25 MÉDIATIONS - Sciences des lieux, sciences des liens
26 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
27 TIMONE - Hôpital de la Timone [CHU - APHM]
28 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
29 Institut Coeur Poumon [CHU Lille]
30 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
31 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
32 Département de cardiologie [CHU de Grenoble]
33 LRB - Radiopharmaceutiques biocliniques
34 CH de Saint-Malo [Broussais]
35 ICANS - Institut de Cancérologie de Strasbourg Europe
36 Nouvel Hôpital Civil de Strasbourg
37 CHU Clermont-Ferrand
38 Université de Clermont-Ferrand
39 Hôpital Lariboisière-Fernand-Widal [APHP]
40 HCL - Hospices Civils de Lyon
41 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
42 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
43 UM - Université de Montpellier
44 Hôpital Haut-Lévêque [CHU Bordeaux]
45 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]

Aims: Published data on cardiogenic shock (CS) are scarce and are mostly focused on small registries of selected populations. The aim of this study was to examine the current CS picture and define the independent correlates of 30 day mortality in a large non-selected cohort.Methods and results: FRENSHOCK is a prospective multicentre observational survey conducted in metropolitan French intensive care units and intensive cardiac care units between April and October 2016. There were 772 patients enrolled (mean age 65.7 ± 14.9 years; 71.5% male). Of these patients, 280 (36.3%) had ischaemic CS. Organ replacement therapies (respiratory support, circulatory support or renal replacement therapy) were used in 58.3% of patients. Mortality at 30 days was 26.0% in the overall population (16.7% to 48.0% depending on the main cause and first place of admission). Multivariate analysis showed that six independent factors were associated with a higher 30 day mortality: age [per year, odds ratio (OR) 1.06, 95% confidence interval (CI): 1.04-1.08], diuretics (OR 1.74, 95% CI: 1.05-2.88), circulatory support (OR 1.92, 95% CI: 1.12-3.29), left ventricular ejection fraction <30% (OR 2.15, 95% CI: 1.40-3.29), norepinephrine (OR 2.55, 95% CI: 1.69-3.84), and renal replacement therapy (OR 2.72, 95% CI: 1.65-4-49).Conclusions: Non-ischaemic CS accounted for more than 60% of all cases of CS. CS is still associated with significant but variable short-term mortality according to the cause and first place of admission, despite frequent use of haemodynamic support, and organ replacement therapies.

Mots clés: Cardiogenic shock; Epidemiology; Mortality; Organ support

Domaines: Sciences du Vivant [q-bio]; Ingénierie biomédicale

Clément Delmas, François Roubille, Nicolas Lamblin, Laurent Bonello, Guillaume Leurent, et al.. Baseline characteristics, management, and predictors of early mortality in cardiogenic shock: insights from the FRENSHOCK registry. ESC Heart Failure, 2022, 9 (1), pp.408-419. ⟨10.1002/ehf2.13734⟩. ⟨hal-03506382v2⟩