Cardiac Shock in Patients Hospitalized for Acute Myocardial Infarction
Bibliographic record
Abstract
Introduction: There is a paucity of data on in-hospital outcomes and mortality in individuals with myocardial infarction (MI) complicated by cardiogenic shock (CS). However, this complication greatly affects prognosis amongst other factors and is a fairly common concern. We aim to add to the existing body of knowledge in this regard. Methods and Results: Patients with MI admitted from January 1, 2005, to December 31, 2014, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the population and selected subgroups. Among 73,573,571 hospitalizations spanning from January 1, 2005, to December 31, 2014, 1,208,029 (1.65%) were attributed to MI. Of these, the number of hospitalized individuals admitted primarily for myocardial infarction with a secondary diagnosis of CS (MICS) was 60,661 (5.02%), 62% (37,885) of which were men. The prevalence by racial ethnicity was 76.13% (39,282) whites, 7.51% (3873) blacks, and (4239) 8.22% Asians. The mean age of all affected with MICS was 68.6 years (SD=13.2). The mortality outcome of the 60661 affected was 21283, i.e., 35.10% mortality. There has been a steady increase in hospitalizations in individuals with myocardial infarction and a secondary diagnosis of cardiogenic shock from 68 per 100 000 hospitalizations in 2005 to 103 per 100 000 hospitalizations in 2014 (p =0.001), it showed 9% vs. 12.2% increase (p =0.001). Of the people that died from MICS, 76.30% (13,754) were white, and Asians and blacks were 8.38% (1,510) and 7.54% (1,359). However, there was no statistical significance in racial differences as p =0.33. Mortality across the various hospital regions showed no statistical significance, p =0.88. However, the mortality among patients with MICS in the in-hospital setting decreased (from 40.80% (2226/5456) in 2005 to 33.70% (2456/7288) in 2014; p =0.001). The mean length of stay (LOS) trend decreased from 9.14 days (SD=10.6) in 2010 to 8.88 days (SD=10.6) in 2013 (p =0.001). There was, however, an upsurge in total hospital charges (CRG) from $147,727 (SD=153,847) in 2010 to $172,357 (SD=201,168) in 2013 (p =0.001). Weekend or weekday admission showed no significant difference in mortality outcome, 73.01% (44,263) vs. 26.99% (16,363) (p =0.18). The adjusted rate for mortality by month revealed that there was a significant increase in in-hospital mortality in December and January (p =0.005). There was a significant difference among patients with congestive cardiac failure (CCF), p =0.001, but type 2 diabetes (T2DM) did not significantly affect the mortality outcomes of these patients. Conclusions: Hospitalizations attributed to MICS rose significantly from January 2005 to December 2014. Our study delineated a decline in MICS in-hospital mortality during this period. Furthermore, a general increase in mortality during December and January was observed in the studied population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".