Abstract 12495: Modes of In-Hospital Death in Patients With Cardiogenic Shock (CS): An Analysis From the Critical Care Cardiology Trials Network (CCCTN)
Bibliographic record
Abstract
Introduction: Mortality from cardiogenic shock (CS), a syndrome of multi-organ system dysfunction, remains high. However, data regarding how patients with CS expire are limited and may have implications for designing clinical trials, identifying therapeutic strategies, and improving outcomes. Aim: We sought to describe primary modes of in-hospital death among patients admitted with CS to cardiac intensive care units (CICUs). Methods: CCCTN is a multi-national research network of advanced CICUs coordinated by the TIMI Study Group (Boston, MA). Using standardized definitions, site investigators classified the direct mode of in-hospital death for patients with CS. Categories included 8 possible modes of cardiovascular (CV) and non-CV death ( Fig ). Subgroups defined by cardiac arrest prior to CICU admission and use of mechanical circulatory support (MCS) were explored. Results: Among 1098 CS cases captured from 10/2021-09/2022, 358 (32.6%) died during the index hospitalization with a median time to death of 4.3 (Q1-Q3, 1.1-10.9) days from CICU admission. Among the deaths, 50%, 41%, and 9% occurred in the context of HF-CS, AMI-CS, and secondary CS, respectively. Overall, mode of death was CV in 82% of cases ( Fig A ). Refractory CS was the dominant mode of death (66%), followed by arrhythmia (13%), anoxic brain injury (6%), and respiratory failure (5%; Fig A ). Compared to patients without preceding cardiac arrest, those with cardiac arrest prior to CICU admission were more likely to die from anoxic brain injury (10% vs. 1%; p<0.01; Fig B ). Compared to patients managed without MCS, those with MCS were more likely to die from refractory shock (p<0.01), either cardiogenic (74% vs. 61%) or non-cardiogenic (6% vs. 3%; Fig C ). Conclusions: Most in-hospital deaths in patients with CS are related to direct CV causes, particularly refractory CS. However, there is potentially important heterogeneity in mode of death across subgroups defined by preceding cardiac arrest and use of MCS.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".